Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 684
Filtrar
1.
J Frailty Aging ; 10(2): 141-149, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33575703

RESUMO

The evaluation of the physical domain represents a critical part of the assessment of the older person, both in the clinical as well as the research setting. To measure physical function, clinicians and researchers have traditionally relied on instruments focusing on the capacity of the individual to accomplish specific functional tasks (e.g., the Activities of Daily Living [ADL] or the Instrumental ADL scales). However, a growing number of physical performance and muscle strength tests has been developed in parallel over the past three decades. These measures are specifically designed to: 1) provide objective results (not surprisingly, they are frequently timed tests) taken in standardized conditions, whereas the traditional physical function scales are generally self- or proxy-reported measures; 2) be more sensitive to changes; 3) capture the real biology of the function through the assessment of standardized tasks mirroring specific functional subdomains; and 4) mirror the quality of specific mechanisms underlying more complex and multidomain functions. Among the most commonly used instruments, the usual gait speed test, the Short Physical Performance Battery, the handgrip strength, the Timed Up-and-Go test, the 6-minute walk test, and the 400-meter walk test are widely adopted by clinicians and researchers. The clinical and research importance of all these instruments has been demonstrated by their predictive capacity for negative health-related outcomes (i.e., hospitalization, falls, institutionalization, disability, mortality). Moreover, they have shown to be associated with subclinical and clinical conditions that are also not directly related to the physical domain (e.g., inflammation, oxidative stress, overall mortality). For this reason, they have been repeatedly indicated as markers of wellbeing linked to the burden of multiple chronic conditions rather than mere parameters of mobility or strength. In this work protocols of the main tests for the objective assessment of physical function in older adults are presented.


Assuntos
Avaliação Geriátrica , Desempenho Físico Funcional , Atividades Cotidianas , Idoso , Idoso de 80 Anos ou mais , Força da Mão/fisiologia , Humanos , Velocidade de Caminhada/fisiologia
2.
Gerokomos (Madr., Ed. impr.) ; 31(4): 204-210, dic. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-198738

RESUMO

OBJETIVOS: Determinar si la velocidad de marcha lenta se asocia a un mayor riesgo de deterioro cognitivo en personas mayores de 60 años, sanas, que viven en la comunidad, e investigar si esta asociación es modificable según niveles de actividad física y tiempo que permanecen sentados. MÉTODOS: Estudio correlacional, transversal y retrospectivo. Se incluyeron 1082 personas mayores de 60 años de la Encuesta Nacional de Salud (ENS) 2009-2010 de Chile. La velocidad de la marcha (normal o lenta) fue autorreportada y el riesgo de deterioro cognitivo se evaluó con el cuestionario Mini-Mental State Examination. Las variables sociodemográficas y de estilos de vida se obtuvieron mediante la aplicación de cuestionarios validados en la ENS 2009-2010. Adicionalmente se evaluó el estado nutricional a través del índice de masa corporal. RESULTADOS: Las personas mayores que presentaban una menor velocidad de marcha evidenciaron un mayor riesgo de presentar deterioro cognitivo en comparación con aquellos que caminan a velocidad de paso normal (OR:1,62 [IC 95%:1,06;2,54], p = 0,036). Esta asociación fue independiente de factores sociodemográficos, obesidad, tiempo sedente, actividad física y estilos de vida. CONCLUSIÓN: Las personas mayores que reportaron caminar a un paso más lento que sus pares de la misma edad presentan un mayor riesgo de deterioro en comparación con aquellos que tienen una velocidad de la marcha normal. La probabilidad de deterioro cognitivo en personas mayores con marcha lenta aumenta en aquellas que no cumplen con las recomendaciones de actividad física dadas por la Organización Mundial de Salud o pasan más de 4 horas diarias en actividades sedentarias. Estos resultados refuerzan la idea de que la velocidad de la marcha podría ser usada como una herramienta de detección de riesgo de deterioro cognitivo en personas mayores


OBJECTIVES: To determine if slow walking speed is associated with an increased risk of cognitive impairment in older Chilean adults, and to investigate if this association is modify according to levels of physical activity (PA) and sitting time. METHODS:1,082 adults over 60 years of age participants from the cross-sectional 2009-2010 Chilean National Health Survey were included in this study. The speed of walking (normal or slow) was self-reported, the risk of cognitive deterioration was assessed with the Mini-Mental State Examination questionnaire. The sociodemographic and lifestyle variables were obtained through the application of questionnaires validated in the ENS 2009-2010, nutritional status was also assessed through body mass index. RESULTS: Older adults who presented a lower walking speed showed a greater risk of presenting cognitive impairment compared to those who walked at a normal gait speed (OR: 1.62 [95% CI: 1.06, 2.54], p = 0.036). This association was independent of sociodemographic, anthropometric, lifestyle variables. CONCLUSION: Older adults who reported walking at a slower gait speed than their peers of the same age presented an increased risk of cognitive impairment compared to those who had a normal gait speed. The probability of cognitive impairment in older adults with slow gait speed increased in those who did not comply with the PA recommendations given by the World Health Organization or had four or more hours per day in sedentary activities


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Velocidade de Caminhada/fisiologia , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/prevenção & controle , Atividade Motora/fisiologia , Estudos Transversais , Estudos Retrospectivos , Inquéritos e Questionários , Estado Nutricional , Índice de Massa Corporal , Estilo de Vida , Comportamento Sedentário
3.
PLoS One ; 15(12): e0242215, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33332421

RESUMO

Step-by-step foot placement control, relative to the center of mass (CoM) kinematic state, is generally considered a dominant mechanism for maintenance of gait stability. By adequate (mediolateral) positioning of the center of pressure with respect to the CoM, the ground reaction force generates a moment that prevents falling. In healthy individuals, foot placement is complemented mainly by ankle moment control ensuring stability. To evaluate possible compensatory relationships between step-by-step foot placement and complementary ankle moments, we investigated the degree of (active) foot placement control during steady-state walking, and under either foot placement-, or ankle moment constraints. Thirty healthy participants walked on a treadmill, while full-body kinematics, ground reaction forces and EMG activities were recorded. As a replication of earlier findings, we first showed step-by-step foot placement is associated with preceding CoM state and hip ab-/adductor activity during steady-state walking. Tight control of foot placement appears to be important at normal walking speed because there was a limited change in the degree of foot placement control despite the presence of a foot placement constraint. At slow speed, the degree of foot placement control decreased substantially, suggesting that tight control of foot placement is less essential when walking slowly. Step-by-step foot placement control was not tightened to compensate for constrained ankle moments. Instead compensation was achieved through increases in step width and stride frequency.


Assuntos
Articulação do Tornozelo/fisiologia , Pé/fisiologia , Modelos Biológicos , Velocidade de Caminhada/fisiologia , Adulto , Fenômenos Biomecânicos , Feminino , Análise da Marcha , Voluntários Saudáveis , Humanos , Modelos Lineares , Masculino , Equilíbrio Postural/fisiologia , Adulto Jovem
4.
Geriatr Gerontol Int ; 20(10): 980-987, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32886834

RESUMO

AIMS: Sarcopenia is a serious problem because of its poor prognosis. Growth differentiation factor 15 (GDF15) is associated with mitochondrial dysfunction, inflammation, insulin resistance and oxidative stress, which may play crucial roles for the development of sarcopenia. We aimed to examine whether serum GDF15 level is associated with muscle mass, strength and lower extremity function in older patients with cardiometabolic disease. METHODS: Serum GDF15 levels were measured in 257 patients with cardiometabolic diseases (including 133 patients with diabetes) who had visited the frailty clinic, using a latex turbidimetric immunoassay. Appendicular skeletal muscle index, handgrip strength, timed-up-and-go test and gait speed were evaluated. Power, speed, balance and total scores based on the sit-to-stand test were calculated to assess lower extremity function. RESULTS: The highest tertile of serum GDF15 was independently associated with low handgrip strength, low gait speed, long timed-up-and-go time and scores of lower extremity function but not an appendicular skeletal muscle index in multiple logistic regression analyses after adjustment for covariates. Patients in the highest tertile of GDF15 were at the risk of having three to nine times lower grip strength, three times lower gait speed, five to six times lower mobility and five to 11 times reduction in lower extremity function as compared with those in the lowest GDF15 tertile dependent on the models. CONCLUSIONS: Elevated serum GDF15 level was independently associated with low muscle strength and lower extremity function in older patients with cardiometabolic disease. Serum GDF15 could be one of the biomarkers for muscle weakness and low physical performance. Geriatr Gerontol Int 2020; 20: 980-987.


Assuntos
Doenças Cardiovasculares/sangue , Diabetes Mellitus/sangue , Fator 15 de Diferenciação de Crescimento/sangue , Extremidade Inferior/fisiopatologia , Força Muscular/fisiologia , Sarcopenia/sangue , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Doenças Cardiovasculares/fisiopatologia , Diabetes Mellitus/fisiopatologia , Feminino , Fragilidade , Força da Mão , Humanos , Masculino , Músculo Esquelético/fisiopatologia , Sarcopenia/fisiopatologia , Estudos de Tempo e Movimento , Velocidade de Caminhada/fisiologia
5.
J Vis Exp ; (162)2020 08 25.
Artigo em Inglês | MEDLINE | ID: mdl-32925877

RESUMO

Gait termination caused by unexpected stimulus is a common occurrence in everyday life. This study presents a protocol to investigate the lower-limb biomechanical changes that occur during unplanned gait termination (UGT) under different walking speeds. Fifteen male participants were asked to perform UGT on a walkway at normal walking speed (NWS) and fast walking speed (FWS), respectively. A motion analysis system and plantar pressure platform were applied to collect lower-limb kinematic and plantar pressure data. Paired-sampled T-test was used to examine the differences in lower-limb kinematics and plantar pressure data between two walking speeds. The results showed larger range of motion in the hip, knee, and ankle joints in the sagittal plane as well as plantar pressure in forefoot and heel regions during UGT at FWS when compared with NWS. With the increase in walking speed, subjects exhibited different lower-limb biomechanical characteristics that show FWS associated with greater potential injury risks.


Assuntos
Extremidade Inferior/fisiologia , Velocidade de Caminhada/fisiologia , Adulto , Fenômenos Biomecânicos/fisiologia , Calibragem , Humanos , Masculino , Movimento (Física) , Pressão , Amplitude de Movimento Articular
6.
Rev. esp. geriatr. gerontol. (Ed. impr.) ; 55(4): 212-215, jul.-ago. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-199469

RESUMO

INTRODUCCIÓN: La fragilidad puede ser detectada con distintas herramientas y en múltiples entornos. Entre los diferentes sistemas de cribado, la velocidad de marcha (VM) y el Timed Up-and- Go (TUG) se postulan como sistemas sencillos y fácilmente aplicables. Existen pocos datos sobre su aplicabilidad en pacientes hospitalizados en centros de atención intermedia. MATERIAL Y MÉTODOS: Estudio descriptivo para determinar la aplicabilidad de la VM y el TUG como herramientas de cribado de fragilidad en un hospital de atención intermedia, así como una estimación de la prevalencia de fragilidad al alta mediante estas pruebas de ejecución funcional. Se consideraron frágiles los pacientes con una VM<1m/s y/o un TUG>12s. Se incluyeron todos pacientes atendidos por la unidad de rehabilitación del centro a lo largo del año 2015. RESULTADOS: Novecientos nueve fueron los pacientes incluidos (edad media de 80,12 años). De estos, solo 205 (22,6%) estaban en condiciones de realizar la VM y TUG en el momento del alta; de estas 205 personas, el 89,8% (VM) y el 92,2% (TUG) presentaban criterios de fragilidad, no habiendo diferencias estadísticamente significativas entre ambas herramientas (p = 0,25). CONCLUSIONES: La utilización de la VM y el TUG para el cribado de fragilidad tiene una aplicabilidad limitada en el entorno de atención intermedia. A pesar de ello, los resultados obtenidos indican una alta prevalencia de fragilidad en este entorno. Serán necesarios más estudios para corroborar estos datos


INTRODUCTION: Frailty screening can be performed with different tools and in multiple settings. Among the different evaluation systems, gait speed (GS) and Timed Up-and-Go (TUG) are postulated as simple and easy to apply systems. There are few data on the prevalence of frailty in intermediate care centre inpatients. MATERIAL AND METHODS: Descriptive study to determine the applicability of GS and TUG as frailty screening tools in an intermediate care hospital, as well as an estimate of frailty prevalence at discharge. Frailty was considered when GS<1m/s and / or TUG>12seconds. The study included all patients attending the rehabilitation unit of the centre throughout 2015. RESULTS: A total of 909 patients were included (mean age of 80.12 years). Only 205 (22.6%) were able to perform GS and TUG at discharge from the rehabilitation unit. Frailty prevalence for this group was between 89.8% (GS) and 92.2% (TUG), with no statistical differences between both tools (P=.25). CONCLUSIONS: The applicability of GS and TUG for frailty screening in intermediate care hospitals is limited. Despite this, the results obtained suggest a high prevalence of frailty. More studies will be necessary to corroborate this data


Assuntos
Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Função Executiva/fisiologia , Testes Neuropsicológicos/estatística & dados numéricos , Fragilidade/diagnóstico , Reprodutibilidade dos Testes , Programas de Rastreamento/métodos , Idoso Fragilizado/psicologia , Instituições para Cuidados Intermediários/estatística & dados numéricos , Epidemiologia Descritiva , Velocidade de Caminhada/fisiologia , Centros de Reabilitação/estatística & dados numéricos , Fragilidade/reabilitação , Estudos Prospectivos
7.
Medicine (Baltimore) ; 99(27): e21042, 2020 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-32629729

RESUMO

BACKGROUND: This systematic review protocol will appraise the effectiveness and safety of electrical stimulation (ES) for limb spasticity (LS) in children with stroke. METHODS: Cochrane Library, EMBASE, PUBMED, PsycINFO, Scopus, OpenGrey, CINAHL, ACMD, CNKI, and WANGFANG will be systematically retrieved for randomized controlled trials (RCTs) testing the effectiveness of ES compared with other interventions on LS in children with stroke. Two independent authors will evaluate eligibility using predefined criteria and will perform data extraction and study quality appraisal of eligible trials. Primary outcomes include gait velocity, and limb spasticity status. Limb function, quality of life, pain intensity, and adverse events will be assessed as secondary outcomes. We will perform data analysis using RevMan 5.3 software. RESULTS: This systematic review will summarize the most recent evidence to assess the effectiveness and safety of ES for LS in children with stroke. CONCLUSIONS: The results of this study may help to determine whether ES is effective or not for LS in children with stroke. STUDY REGISTRATION: INPLASY202050115.


Assuntos
Terapia por Estimulação Elétrica/métodos , Espasticidade Muscular/terapia , Acidente Vascular Cerebral/complicações , Criança , Terapia por Estimulação Elétrica/efeitos adversos , Humanos , Espasticidade Muscular/psicologia , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Segurança , Resultado do Tratamento , Velocidade de Caminhada/fisiologia
8.
PLoS One ; 15(7): e0235277, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32628686

RESUMO

BACKGROUND AND AIMS: The aim of this study was to investigate the association between walking speed and cardiovascular disease (CVD) risk among community-dwelling middle-aged and elderly populations in Taiwan. METHODS: This was a cross-sectional and community-based study with 400 participants aged 50 years and over recruited from a community health promotion project in 2014 in Guishan district, Taoyuan city. We excluded 91 people, and a total of 309 participants were eligible for analysis. The statistical methods used in this study were one-way ANOVA and the Chi-square test, Pearson's correlation test and logistic regression model. RESULTS: In total, 309 participants (98 males and 211 females) aged 50 to 74 (62.05 ± 6.21) years without a CVD history were enrolled in this study. The walking speed gradually decreased from the low CVD risk group to the high CVD risk group (p < 0.05). A significant inverse association between walking speed and CVD risk was confirmed with a Pearson's correlation coefficient of-0.143 (p < 0.05) in middle-aged people, but this significant inverse association was not shown in elderly people. The multivariate logistic regression model for predicting CVD risk and walking speed with an adjusted odds ratio (OR) was 0.127 (95% CI = 0.021-0.771) in middle-aged people with adjustment for sex, age, waist circumference (WC), hypertension (HTN), diabetes mellitus (DM), and hyperlipidemia (p < 0.05). CONCLUSION: Our study clearly shows that slow walking speed is associated with an increased risk of CVD in middle-aged people rather than in elderly people.


Assuntos
Doenças Cardiovasculares/epidemiologia , Diabetes Mellitus/epidemiologia , Hiperlipidemias/epidemiologia , Hipertensão/epidemiologia , Velocidade de Caminhada/fisiologia , Idoso , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/fisiopatologia , Estudos Transversais , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/fisiopatologia , Feminino , Humanos , Hiperlipidemias/diagnóstico , Hiperlipidemias/fisiopatologia , Hipertensão/diagnóstico , Hipertensão/fisiopatologia , Vida Independente , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Prognóstico , Fatores de Risco , Inquéritos e Questionários , Taiwan/epidemiologia , Circunferência da Cintura
9.
Rev Lat Am Enfermagem ; 28: e3282, 2020.
Artigo em Português, Espanhol, Inglês | MEDLINE | ID: mdl-32491121

RESUMO

OBJECTIVE: to know the relationship between the sensory function, gait ability, and cognitive function with dependency in older adults. METHOD: a descriptive cross-sectional design, 146 older adults took part. MEASUREMENTS: Snellen chart, Audiometer, Stereognosia tests, Semmes-Weinstein monofilament, basic aromas and flavors, GAITRite system, Montreal Cognitive Assessment Test, the Barthel Index, and the Lawton and Brody Index. RESULTS: sensory function, cognitive function and gait explain 25% dependence on basic activities of daily life and 21% dependence on instrumental activities of daily life. The variables that influence dependence on basic activities were taste (p=.029), gait speed (p=.009), cadence (p=.002) and step length (p=.001) and, in instrumental activities, gait speed (p=.049), cadence (p=.028) and step length (p=.010). CONCLUSION: gait speed, cadence and stride length are variables that influence both dependence on basic and instrumental activities of daily life.


Assuntos
Cognição/fisiologia , Marcha/fisiologia , Atividades Cotidianas , Idoso , Estudos Transversais , Feminino , Análise da Marcha , Humanos , Masculino , Pessoa de Meia-Idade , Velocidade de Caminhada/fisiologia
10.
PLoS One ; 15(6): e0234904, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32584912

RESUMO

BACKGROUND: Falls in the elderly are a major public health concern because of their high incidence, the involvement of many risk factors, the considerable post-fall morbidity and mortality, and the health-related and social costs. Given that many falls are preventable, the early identification of older adults at risk of falling is crucial in order to develop tailored interventions to prevent such falls. To date, however, the fall-risk assessment tools currently used in the elderly have not shown sufficiently high predictive validity to distinguish between subjects at high and low fall risk. Consequently, predicting the risk of falling remains an unsolved issue in geriatric medicine. This one-year prospective study aims to develop and validate, by means of a cross-validation method, a multifactorial fall-risk model based on clinical and robotic parameters in older adults. METHODS: Community-dwelling subjects aged ≥ 65 years were enrolled. At the baseline, all subjects were evaluated for history of falling and number of drugs taken daily, and their gait and balance were evaluated by means of the Timed "Up & Go" test (TUG), Gait Speed (GS), Short Physical Performance Battery (SPPB) and Performance-Oriented Mobility Assessment (POMA). They also underwent robotic assessment by means of the hunova robotic device to evaluate the various components of balance. All subjects were followed up for one-year and the number of falls was recorded. The models that best predicted falls-on the basis of: i) only clinical parameters; ii) only robotic parameters; iii) clinical plus robotic parameters-were identified by means of a cross-validation method. RESULTS: Of the 100 subjects initially enrolled, 96 (62 females, mean age 77.17±.49 years) completed the follow-up and were included. Within one year, 32 participants (33%) experienced at least one fall ("fallers"), while 64 (67%) did not ("non-fallers"). The best classifier model to emerge from cross-validated fall-risk estimation included eight clinical variables (age, sex, history of falling in the previous 12 months, TUG, Tinetti, SPPB, Low GS, number of drugs) and 20 robotic parameters, and displayed an area under the receiver operator characteristic (ROC) curve of 0.81 (95% CI: 0.72-0.90). Notably, the model that included only three of these clinical variables (age, history of falls and low GS) plus the robotic parameters showed similar accuracy (ROC AUC 0.80, 95% CI: 0.71-0.89). In comparison with the best classifier model that comprised only clinical parameters (ROC AUC: 0.67; 95% CI: 0.55-0.79), both models performed better in predicting fall risk, with an estimated Net Reclassification Improvement (NRI) of 0.30 and 0.31 (p = 0.02), respectively, and an estimated Integrated Discrimination Improvement (IDI) of 0.32 and 0.27 (p<0.001), respectively. The best model that comprised only robotic parameters (the 20 parameters identified in the final model) achieved a better performance than the clinical parameters alone, but worse than the combination of both clinical and robotic variables (ROC AUC: 0.73, 95% CI 0.63-0.83). CONCLUSION: A multifactorial fall-risk assessment that includes clinical and hunova robotic variables significantly improves the accuracy of predicting the risk of falling in community-dwelling older people. Our data suggest that combining clinical and robotic assessments can more accurately identify older people at high risk of falls, thereby enabling personalized fall-prevention interventions to be undertaken.


Assuntos
Acidentes por Quedas/prevenção & controle , Avaliação Geriátrica/métodos , Vida Independente/estatística & dados numéricos , Robótica , Acidentes por Quedas/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Incidência , Masculino , Equilíbrio Postural/fisiologia , Estudos Prospectivos , Medição de Risco/métodos , Velocidade de Caminhada/fisiologia
11.
Phys Ther ; 100(9): 1568-1581, 2020 08 31.
Artigo em Inglês | MEDLINE | ID: mdl-32542356

RESUMO

OBJECTIVE: Trunk training after stroke is an effective method for improving mobility, yet underlying associations leading to the observed mobility carryover effects are unknown. The purposes of this study were to investigate the effectiveness of trunk training for gait and trunk kinematics and to find explanatory variables for the mobility carryover effects. METHODS: This study was an assessor-masked, randomized controlled trial. Participants received either additional trunk training (n = 19) or cognitive training (n = 20) after subacute stroke. Outcome measures were the Tinetti Performance-Oriented Mobility Assessment (POMA), the Trunk Impairment Scale, spatiotemporal gait parameters, center-of-mass excursions, and trunk and lower limb kinematics during walking. Multivariate analysis with post hoc analysis was performed to observe treatment effects. Correlation and an exploratory regression analysis were used to examine associations with the mobility carryover effects. RESULTS: Significant improvements after trunk training, compared with the findings for the control group, were found for the Trunk Impairment Scale, Tinetti POMA, walking speed, step length, step width, horizontal/vertical center-of-mass excursions, and trunk kinematics. No significant differences were observed in lower limb kinematics. Anteroposterior excursions of the trunk were associated with 30% of the variability in the mobility carryover effects. CONCLUSIONS: Carryover effects of trunk control were present during ambulation. Decreased anteroposterior movements of the thorax were the main variable explaining higher scores on the Tinetti POMA Gait subscale. However, the implementation and generalizability of this treatment approach in a clinical setting are laborious and limited, necessitating further research. IMPACT: Trunk training is an effective strategy for improving mobility after stroke. Regaining trunk control should be considered an important treatment goal early after stroke to adequately prepare patients for walking.


Assuntos
Marcha/fisiologia , Reabilitação do Acidente Vascular Cerebral/métodos , Tronco/fisiologia , Fenômenos Biomecânicos , Cognição , Feminino , Humanos , Extremidade Inferior/fisiopatologia , Masculino , Pessoa de Meia-Idade , Equilíbrio Postural/fisiologia , Método Simples-Cego , Acidente Vascular Cerebral/complicações , Resultado do Tratamento , Velocidade de Caminhada/fisiologia
12.
Geriatr Gerontol Int ; 20(7): 664-669, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32378318

RESUMO

AIM: Walking speed is closely related to numerous health outcomes. It has typically been measured in laboratory settings, where individuals can intentionally change their walking speed. It can be accurately measured in daily life using a smartphone global positioning system. We aimed to present a reference value on walking speed in daily life by sex and age. METHODS: The data were obtained using a walking monitoring service involving global positioning system technology. A secondary data analysis was carried out. Four daily living walking parameters - daily living walking speed, daily living walking cycle, daily living step length and daily living cadence - of 8429 Japanese persons were measured in their daily life using a smartphone application. RESULTS: The means (standard deviations) of daily living walking speed, daily living walking cycle, daily living step length and daily living cadence were 1.30 m/s (0.10 m/s), 1.02 s (0.06 s), 65.55 cm (5.38 cm) and 118.86 steps/min (6.76 steps/min), respectively. Notably, daily living walking speed in those aged >65 years was significantly slower than in those aged <65 years. CONCLUSIONS: The present reference values and age differences of daily living walking parameters can be used to compare daily living walking speed data measured by other devices, such as accelerometers. This could allow for a consensus on the definition of daily walking speed that can be utilized for assessing health outcomes among older individuals. Geriatr Gerontol Int 2020; 20: 664-669.


Assuntos
Velocidade de Caminhada/fisiologia , Atividades Cotidianas , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Aplicativos Móveis , Valores de Referência , Smartphone
13.
Geriatr Gerontol Int ; 20(7): 680-684, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32432835

RESUMO

AIMS: This study examined the effects of the starting position, distance and ending point on walking speed in older adults with both the usual and maximum walking speeds. METHODS: In total, 101 older community-dwellers aged between 60 and 74 years were included in this cross-sectional study. Participants were instructed to walk two distances (i.e., 10 and 25 m) at usual and maximum speeds twice. The paired t-test was used to examine the effects of starting positions (static start vs. dynamic start) and ending points (known vs. unknown ending point) on walking speed. Analysis of variance was used to explore walking speed differences among 4, 6, 8, 10, 15, 20 and 25 m walking tests. RESULTS: Differences in walking speed between static start and dynamic start became larger with a decrease in the walking distance (Cohen's d: 4 m > 6 m > 10 m), and differences were larger in tests at the maximum walking speed (Cohen's d = 0.28-0.85) compared with those at usual walking speed (Cohen's d = 0.21-0.67). The walking speed increased with distance, but no significant changes were found among 10, 15, 20 and 25 m tests at the usual speed. Trivial speed differences were observed in walking speed between known (mean = 1.23-1.82 m/s) and unknown ending points (mean = 1.27-1.86 m/s; Cohen's d < 0.20). CONCLUSIONS: Test parameters, particularly the starting position and walk distance, do influence walking speed measured in the short-distance walking speed test among older adults. Geriatr Gerontol Int ••; ••: ••-•• Geriatr Gerontol Int 2020; ••: ••-••.


Assuntos
Teste de Caminhada/métodos , Velocidade de Caminhada/fisiologia , Idoso , Estudos Transversais , Feminino , Humanos , Vida Independente , Masculino
14.
Clin Interv Aging ; 15: 567-574, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32368023

RESUMO

Introduction: Completion of the SARC-F questionnaire constitutes the obligatory first step in the diagnostic process of sarcopenia, according to the revised European consensus on the definition and diagnosis of sarcopenia published by the European Working Group on Sarcopenia in Older People2 (EWGSOP2). SARC-F has been recognized as the most up-to-date and coherent screening tool for sarcopenia. The aim of the study was to translate and to validate the Polish version of the SARC-F questionnaire. Materials and Methods: The validation process was performed in two stages: 1) translation and intercultural adaptation and 2) clinical validation. The inclusion criteria were as follows: age ≥65 years, unimpaired mobility, and no cognitive impairment. The EWGSOP2 criteria were used to diagnose sarcopenia. Hand grip strength measurement, physical fitness test, and body weight composition analysis were conducted. Sensitivity, specificity, accuracy-likelihood ratios, and SARC-F predictive values were calculated using the EWGSOP2 criteria. Results: Sixty-seven people participated in the study of whom 21% were diagnosed with sarcopenia (SARC-F score: ≥4). The reliability of the questionnaire based on the Cronbach's alpha coefficient was 0.784. Sensitivity, specificity, and negative predictive values were 92.9%, 98.1%, and 98.1%, respectively. Conclusion: The process of validating the SARC-F questionnaire against Polish conditions demonstrated its applicability as a simple and reliable tool for diagnosing sarcopenia in daily clinical practice with older adults.


Assuntos
Sarcopenia/diagnóstico , Inquéritos e Questionários/normas , Traduções , Idoso , Estudos Transversais , Feminino , Avaliação Geriátrica/métodos , Força da Mão , Humanos , Masculino , Programas de Rastreamento , Polônia , Reprodutibilidade dos Testes , Velocidade de Caminhada/fisiologia
15.
Stroke ; 51(5): 1388-1395, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32299326

RESUMO

Background and Purpose- Stroke incidence in younger and middle-aged people is growing. Despite this, its associations in this subset of the stroke population are unknown, and prevention strategies are not tailored to meet their needs. This study examined the association between self-reported walking pace and incident stroke. Methods- Data from the UK Biobank were used in a prospective population-based study. Three hundred and sixty-three thousand, one hundred and thirty-seven participants aged 37 to 73 years (52% women) were recruited. The associations of self-reported walking pace with stroke incidence over follow-up were investigated using Cox proportional-hazard models. Results- Among 363,137 participants, 2705 (0.7%) participants developed a fatal or nonfatal stroke event over the mean follow-up period of 6.1 years (interquartile range, 5.4-6.7). Slow walking pace was associated with a higher hazard for stroke incidence (hazard ratio [HR], 1.45 [95% CI, 1.26-1.66]; P<0.0001). Stroke incidence was not associated with walking pace among people <65 years of age. However, slow walking pace was associated with a higher risk of stroke among participants aged ≥65 years (HR, 1.42 [95% CI, 1.17-1.72]; P<0.0001). A higher risk for stroke was observed on those with middle (HR, 1.28 [95% CI, 1.01-1.63]; P=0.039) and higher (HR, 1.29 [95% CI, 1.05-1.69]; P=0.012) deprivation levels but not in the least deprived individuals. Similarly, overweight (HR, 1.30 [95% CI, 1.04-1.63]; P=0.019) and obese (HR, 1.33 [95% CI, 1.09-1.63]; P=0.004) but not normal-weight individuals had a higher risk of stroke incidence. Conclusions- Slow walking pace was associated with a higher risk of stroke among participants over 64 years of age in this population-based cohort study. The addition of the measurement of self-reported walking pace to primary care or public health clinical consultations may be a useful screening tool for stroke risk.


Assuntos
Doenças Cardiovasculares/epidemiologia , Acidente Vascular Cerebral/epidemiologia , Velocidade de Caminhada/fisiologia , Caminhada/fisiologia , Adulto , Idoso , Bancos de Espécimes Biológicos , Estudos de Coortes , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Atividade Motora/fisiologia , Estudos Prospectivos , Fatores de Risco , Reino Unido/epidemiologia
16.
Arch Phys Med Rehabil ; 101(7): 1183-1189, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32272105

RESUMO

OBJECTIVES: To establish reference values for the 2-minute walk test (2-MWT) distance and gait speed in people with a lower limb amputation (LLA) who are prosthetic ambulators. Also, to describe the differences in distance and gait speed between sexes, causes of amputation, levels of amputation, health risk classification, functional levels, and age groups. DESIGN: Cross-sectional study. SETTING: National meeting for people with lower limb amputation. PARTICIPANTS: A convenience sample of unilateral people (N=101; 47 men, 54 women; mean age ± SD, 50.9±14.3 y) with an LLA; 48 had a transtibial amputation and 53 had a transfemoral amputation. Participants were classified as either limited community ambulators, community ambulators, or those who exceed basic ambulation skills (K2, n=7; K3, n=70; K4, n=24). INTERVENTION: Not applicable. MAIN OUTCOME MEASURE: 2-MWT performance (ie, distance and gait speed). RESULTS: The mean ± SD 2-MWT distance and gait speed for the entire sample was 143.8±37.5 meters (range, 49-259 m) and 72.1±18.8 meters per minute (range, 25-130 m/min), respectively. Men walked farther (distance: men, 154.2±34.2 m; women, 134.4±38.1 m) and faster (gait speed: men, 77.3±17.1 m/min; women, 67.4±19.1 m/min) than women (P<.05). The mean ± SD 2-MWT distance for K4, K3, and K2 level participants was 177.9±31.1 meters, 138.4±28.5 meters, and 81.7±26.9 meters, respectively. Functional level K4 participants performed better than K3 participants (P<.05), and K3 participants performed better than K2 participants (P<.05). People with transtibial amputation walked farther than those with transfemoral amputation (152.9±43.0 m vs 135.6±43.0 m) (P<.05). The distance and speed ambulated by those participants classified in the very high health risk group was worse than those categorized as being at an increased high health risk group (P<.05) and the no increase health risk group (P<.05). The performance of participants older than 70 years old was inferior to the performance of all younger age groups. CONCLUSIONS: Reference values for the 2-MWT distance and gait speed were established in people with LLA who are prosthetic ambulators. Significant differences in the 2-MWT performance were found between sexes, causes of amputation, levels of amputation, health risk classification, functional levels, and age groups.


Assuntos
Amputação/reabilitação , Amputados/reabilitação , Membros Artificiais , Extremidade Inferior/cirurgia , Teste de Caminhada/estatística & dados numéricos , Velocidade de Caminhada/fisiologia , Adulto , Idoso , Amputação/métodos , Estudos Transversais , Feminino , Fêmur/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Limitação da Mobilidade , Equilíbrio Postural/fisiologia , Ajuste de Prótese/métodos , Qualidade de Vida , Tíbia/cirurgia , Fatores de Tempo , Resultado do Tratamento , Estados Unidos , Teste de Caminhada/métodos , Caminhada/fisiologia
17.
Qual Life Res ; 29(9): 2375-2381, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32253669

RESUMO

PURPOSE: Social isolation in older adults is a major public health problem and associated with increased morbidity and mortality. There are limited data on the association between social isolation and physical function including gait speed. Hence, this study is to determine the prevalence of social isolation and its association with gait speed, frailty, cognition, depression and comorbidities amongst community-dwelling older adults. METHODS: Social isolation, depression, frailty and perceived general health were assessed using 6-item Lubben Social Network Scale (LSNS-6), Geriatric Depression Scale (GDS), FRAIL scale and EuroQol EQ-5D-5L questionnaire which includes EQ Visual Analogue Scale (EQ-VAS), respectively. Cognition was assessed using the Chinese Mini Mental State Examination (cMMSE), while physical performance test included gait speed and short physical performance battery test. Binary logistic regression was performed to determine the influence of socio-demographic, medical, functional and cognitive variables on social isolation. RESULTS: Out of 202 participants, 27.7% were robust, 66.8% of participants were pre-frail, and 5.4% of participants were frail. Almost half (45.5%, n = 92) of the participants were found to be at risk of social isolation. A poor social network was negatively associated with mean gait speed (OR = 0.674, CI 0.464-0.979, p = 0.039), EQ-VAS (OR = 0.561, CI 0.390-0.806, p < 0.01) and cMMSE (OR = 0.630, 95% CI 0.413-0.960, p = 0.032). CONCLUSION: Almost half of older adults in the community are at risk of social isolation with a very significant association with gait speed, cMMSE and EQ-VAS scores.


Assuntos
Vida Independente/psicologia , Qualidade de Vida/psicologia , Isolamento Social/psicologia , Velocidade de Caminhada/fisiologia , Idoso , Idoso de 80 Anos ou mais , Cognição/fisiologia , Comorbidade , Estudos Transversais , Depressão/psicologia , Feminino , Idoso Fragilizado/psicologia , Fragilidade , Avaliação Geriátrica , Humanos , Modelos Logísticos , Masculino , Testes de Estado Mental e Demência , Prevalência , Psicometria , Inquéritos e Questionários
18.
J Frailty Aging ; 9(2): 82-89, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32259181

RESUMO

BACKGROUND: Muscle mass is often mentioned not to reflect muscle strength. For muscle mass assessment skeletal muscle index (SMI) is often used. We have reported that dual-energy X-ray absorptiometry (DXA)-derived SMI does not change with age in women, whereas the cross-sectional muscle area (CSMA) derived from computed tomography (CT) does. OBJECTIVES: The present study aimed to compare CT and DXA for the assessment of muscle tissue. DESIGN AND SETTING: Cross-sectional study in the local residents. PARTICIPANTS: A total of 1818 subjects (age 40-89 years) randomly selected from community dwellers underwent CT examination of the right mid-thigh to measure the cross-sectional muscle area (CSMA). Skeletal muscle mass (SMM) was measured by DXA. The subjects performed physical function tests such as grip strength, knee extension strength, leg extension strength, and gait speed. The correlation between CT-derived CSMA and DXA-derived SMM along with their association with physical function was examined. RESULTS: After controlling for related factors, the partial correlation coefficient of muscle cross-sectional area (CSA) with physical function was larger than that of DXA-derived SMM for gait speed in men (p=0.002) and knee extension strength in women (p=0.03). The partial correlation coefficient of quadriceps (Qc) CSA with physical function was larger than that of DXA-derived SMM for leg extension power in both sexes (p=0.01), gait speed in men (p<0.001), and knee extension strength in women (p<0.001). CONCLUSION: Mid-thigh CT-derived CSMA, especially Qc CSA, showed significant associations with grip strength, knee extension strength, and leg extension power, which were equal to or stronger than those of DXA-derived SMM in community-dwelling middle-aged and older Japanese people. The mid-thigh CSMA may be a predictor of mobility disability, and is considered to be useful in the diagnosis of sarcopenia.


Assuntos
Força Muscular/fisiologia , Músculo Esquelético/anatomia & histologia , Músculo Esquelético/diagnóstico por imagem , Velocidade de Caminhada/fisiologia , Absorciometria de Fóton , Adulto , Idoso , Idoso de 80 Anos ou mais , Anatomia Transversal , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Sarcopenia/diagnóstico , Coxa da Perna/diagnóstico por imagem , Tomografia Computadorizada por Raios X
19.
PLoS One ; 15(3): e0229979, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32155194

RESUMO

BACKGROUND: While physical frailty and malnutrition/obesity (parameters easily measured by a nurse) are not the same, older persons who are malnourished/obese are more likely to be frail and there is a potential overlap between these conditions. The objective was to examine the relationship between gait speed (GS) and body mass index (BMI) in men and women aged 75 years and older. DESIGN: Cross-sectional analysis. SETTING, PARTICIPANTS: Data from the Aging Multidisciplinary Investigation (AMI), a French prospective cohort study with participants randomly selected from the farmer Health Insurance rolls. MEASUREMENTS: Usual GS was measured over a 4 meters-track. BMI was categorized using clinical cut-points for European populations: (e.g, <20.0 kg/m2; 20.0-24.9 kg/m2; 25.0-29.9 kg/m2; 30.0-34.9 kg/m2; ≥35.0 kg/m2). RESULTS: The current analyses were performed in 449 participants. Mean age was 81 years. Being malnourished/obese was significantly associated with slow GS. Unadjusted and age-adjusted models showed that underweight, overweight and obesity statuses were significantly associated with slow GS for both women (0.83m/s [0.61; 1.04], 0.87m/s [0.72; 1.02], 0.70 m/s [0.41; 0.98], respectively) and men (0.83m/s [0.61; 1.04], 1.11m/s [1.03; 1.20], 0.97m/s [0.75; 1.19], respectively). CONCLUSION: Malnourished/obese are associated with slow GS in older persons. These variables could be contributed at comprehensively and complementarily assessing the older person.


Assuntos
Fragilidade/diagnóstico , Avaliação Geriátrica/métodos , Desnutrição/complicações , Sobrepeso/complicações , Idoso , Idoso de 80 Anos ou mais , Envelhecimento/fisiologia , Índice de Massa Corporal , Estudos Transversais , Feminino , Fragilidade/etiologia , Fragilidade/fisiopatologia , Humanos , Masculino , Desnutrição/fisiopatologia , Sobrepeso/fisiopatologia , Estudos Prospectivos , Fatores de Risco , Velocidade de Caminhada/fisiologia
20.
Cochrane Database Syst Rev ; 3: CD003316, 2020 03 20.
Artigo em Inglês | MEDLINE | ID: mdl-32196635

RESUMO

BACKGROUND: Levels of physical activity and physical fitness are low after stroke. Interventions to increase physical fitness could reduce mortality and reduce disability through increased function. OBJECTIVES: The primary objectives of this updated review were to determine whether fitness training after stroke reduces death, death or dependence, and disability. The secondary objectives were to determine the effects of training on adverse events, risk factors, physical fitness, mobility, physical function, health status and quality of life, mood, and cognitive function. SEARCH METHODS: In July 2018 we searched the Cochrane Stroke Trials Register, CENTRAL, MEDLINE, Embase, CINAHL, SPORTDiscus, PsycINFO, and four additional databases. We also searched ongoing trials registers and conference proceedings, screened reference lists, and contacted experts in the field. SELECTION CRITERIA: Randomised trials comparing either cardiorespiratory training or resistance training, or both (mixed training), with usual care, no intervention, or a non-exercise intervention in stroke survivors. DATA COLLECTION AND ANALYSIS: Two review authors independently selected studies, assessed quality and risk of bias, and extracted data. We analysed data using random-effects meta-analyses and assessed the quality of the evidence using the GRADE approach. Diverse outcome measures limited the intended analyses. MAIN RESULTS: We included 75 studies, involving 3017 mostly ambulatory participants, which comprised cardiorespiratory (32 studies, 1631 participants), resistance (20 studies, 779 participants), and mixed training interventions (23 studies, 1207 participants). Death was not influenced by any intervention; risk differences were all 0.00 (low-certainty evidence). There were few deaths overall (19/3017 at end of intervention and 19/1469 at end of follow-up). None of the studies assessed death or dependence as a composite outcome. Disability scores were improved at end of intervention by cardiorespiratory training (standardised mean difference (SMD) 0.52, 95% CI 0.19 to 0.84; 8 studies, 462 participants; P = 0.002; moderate-certainty evidence) and mixed training (SMD 0.23, 95% CI 0.03 to 0.42; 9 studies, 604 participants; P = 0.02; low-certainty evidence). There were too few data to assess the effects of resistance training on disability. Secondary outcomes showed multiple benefits for physical fitness (VO2 peak and strength), mobility (walking speed) and physical function (balance). These physical effects tended to be intervention-specific with the evidence mostly low or moderate certainty. Risk factor data were limited or showed no effects apart from cardiorespiratory fitness (VO2 peak), which increased after cardiorespiratory training (mean difference (MD) 3.40 mL/kg/min, 95% CI 2.98 to 3.83; 9 studies, 438 participants; moderate-certainty evidence). There was no evidence of any serious adverse events. Lack of data prevents conclusions about effects of training on mood, quality of life, and cognition. Lack of data also meant benefits at follow-up (i.e. after training had stopped) were unclear but some mobility benefits did persist. Risk of bias varied across studies but imbalanced amounts of exposure in control and intervention groups was a common issue affecting many comparisons. AUTHORS' CONCLUSIONS: Few deaths overall suggest exercise is a safe intervention but means we cannot determine whether exercise reduces mortality or the chance of death or dependency. Cardiorespiratory training and, to a lesser extent mixed training, reduce disability during or after usual stroke care; this could be mediated by improved mobility and balance. There is sufficient evidence to incorporate cardiorespiratory and mixed training, involving walking, within post-stroke rehabilitation programmes to improve fitness, balance and the speed and capacity of walking. The magnitude of VO2 peak increase after cardiorespiratory training has been suggested to reduce risk of stroke hospitalisation by ˜7%. Cognitive function is under-investigated despite being a key outcome of interest for patients. Further well-designed randomised trials are needed to determine the optimal exercise prescription, the range of benefits and any long-term benefits.


Assuntos
Terapia por Exercício/métodos , Aptidão Física , Reabilitação do Acidente Vascular Cerebral , Caminhada/fisiologia , Atividades Cotidianas , Humanos , Pessoa de Meia-Idade , Força Muscular , Consumo de Oxigênio , Desempenho Físico Funcional , Equilíbrio Postural , Ensaios Clínicos Controlados Aleatórios como Assunto , Treinamento de Resistência , Acidente Vascular Cerebral/mortalidade , Sobreviventes , Velocidade de Caminhada/fisiologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...