Clinical prediction rule for locomotive syndrome in older adults: A decision tree model.

BACKGROUND: No previous studies have proposed a clinical prediction rule that analyzes the factors related to the severity of locomotive syndrome. This study developed and assessed a clinical prediction rule for the severity of locomotive syndrome in older adults. METHODS: A total of 186 patients were assessed using the locomotive syndrome risk test. Classification and regression tree methodologies were used to develop the clinical prediction rule. This study developed three prediction models based on the severity of the locomotive syndrome, of which Model 3 assessed the most severe condition. The following potential predictive factors were measured and entered into each model; single-leg standing time, grip strength, preferred and maximum walking time, and timed up and go test. RESULTS: The single-leg standing test (≤59.4 or >59.4 s) was the best single discriminator for Model 1. Among those with a single-leg standing time >59.4 s, the next best predictor was grip strength (≤37.8 or >37.8 kg). In Model 2, the single-leg standing test was also the best single discriminator (≤12.6 or >12.6 s). Among those with a single-leg standing time ≤12.6, the next best predictor was TUG (≤7.9 or >7.9 s). Additionally, among those with a single-leg standing time >12.6, the next best predictor was single-leg standing time (≤55.3 or >55.3 s). In Model 3, predictive value in Model 2 was the best single discriminator (0 or 1). Among those with 1, the next best predictor was maximum walking time (≤3.75 or >3.75 s). The area under the receiver operating characteristic curves of Models 1, 2, and 3 were 0.737, 0.763, and 0.704, respectively. CONCLUSIONS: A clinical prediction rule was developed to assess the accuracy of the models. These results can be used to screen older adults for suspected locomotive syndrome.

Effects of Non-Face-to-Face and Noncontact Interventions on Knee Pain and Physical Activity in Older Adults With Knee Osteoarthritis: A Systematic Review and Meta-Analysis.

Increased physical activity is an effective treatment for knee osteoarthritis that causes knee pain. However, due to the coronavirus disease 2019, noncontact and non-face-to-face interventions have increased, but the quality of evidence supporting their effectiveness remains unclear. The purpose of the study was to assess the quality of evidence of the effects of non-face-to-face and noncontact interventions on knee pain and physical activity in older adults with knee osteoarthritis. A meta-analysis was conducted to determine the effects of different intervention methods (education and exercise). The Cochrane Central Register of Controlled Trials, PubMed, Cumulative Index to Nursing and Allied Health Literature, and Physiotherapy Evidence Database were systematically searched. Four randomized controlled trials were included in the analysis. The meta-analysis demonstrated that the educational intervention group was significantly effective, although supportive evidence was low quality. Educational intervention may be effective, but the effects need to be confirmed by higher quality clinical trials.

A cutoff value for body composition on the severity of locomotive syndrome in Japanese older women: A cross-sectional study.

We aimed to investigate the relationship between body compositions and locomotive syndrome in older women and derive body composition cutoff values to evaluate locomotive syndrome severity. In total, 236 women were included in this study. The percentage of body fat and skeletal muscle mass index was measured using multi-frequency bioelectrical impedance analysis. The locomotive syndrome severity (stage 0-3) was determined using the standup test, the two-step test, and a self-administered questionnaire. The receiver operating characteristic curve analysis indicated that the cutoff value for body fat percentage was 33.1% for locomotive syndrome stage 1 in women. This finding may aid in designing exercise and nutritional interventions to prevent locomotive syndrome in older women.

A clinical prediction rule for predicting a delay in quality of life recovery at 1 month after total knee arthroplasty: A decision tree model.

BACKGROUND: There is no clinical prediction rule for predicting the prognosis of quality of life after total knee arthroplasty and for assessing its accuracy. The study aimed to develop and assess a clinical prediction rule to predict decline in quality of life at 1 month after total knee arthroplasty. METHODS: This study included 116 patients with total knee arthroplasty in Japan. Potential predictors such as sociodemographic factors, medical information, and motor functions were measured. Quality of life was measured using the Japanese Knee Osteoarthritis Measure at 1 day before surgery and 1 month after total knee arthroplasty. The classification and regression tree methodology was used for developing a clinical prediction rule. RESULTS: The Japanese Knee Osteoarthritis Measure score pre-total knee arthroplasty (≦34.0 or >34.0) was the best single discriminator. Among those with the Japanese Knee Osteoarthritis Measure score pre-total knee arthroplasty ≦34.0, the next best predictor was knee flexor muscle strength on the affected side (≦0.45 or >0.45 N m/kg). Among those with knee flexor muscle strength on the affected side >0.45, the next predictor was knee flexion range of motion on the affected side (≦132.5°or >132.5°). The area under the receiver operating characteristic curves of the model was 0.805 (95% confidence interval, 0.701-0.909). CONCLUSIONS: In this study, 4 variables were selected as the significant predictor. However, the results of knee flexor muscle strength and knee flexion range of motion were paradoxical. This result suggests that it should be careful to perform surgery to the patients with good preoperative knee function. The clinical prediction rule was developed for predicting quality of life decline 1 month after total knee arthroplasty, and the accuracy was moderate. This clinical prediction rule can be used for screening of patients with total knee arthroplasty.

Identifying Activity Limitation and Decline in Quality of Life in Patients with Knee Osteoarthritis Who Are Scheduled to Undergo Total Knee Arthroplasty.

This study examines factors associated with activity limitation and the decline in quality of life in patients with knee osteoarthritis (OA), and to determine standard values that would be useful for understanding the disease state. We assessed individual factors, the modified version of the Self-Rating Frenchay Activities Index (SR-FAI), and the Japanese Knee Osteoarthritis Measure (JKOM) of 661 participants. Multiple regression analyses were used to examine the relationship between dependent and explanatory variables. Standard values were calculated after stratifying based on factors related to each dependent variable through multiple regression analyses. Among the participants aged 60-74/75-89 years, the standard values for the modified SR-FAI were 23/19 and 20/18 points for K-L grades III and IV in the males, and 29/23 and 26/21 points in the females, respectively. The standard values for the JKOM were 35/49 and 45/59 points for K-L grades III and IV in the males and 41/52 and 47/60 points in the females, respectively. These standard values are a useful index for interpreting the degree of activity limitation and satisfaction reduction in patients with knee OA, and could help in clinical decision making for healthcare providers.

Factors characterizing gait performance of patients before and soon after knee arthroplasty.

[Purpose] For monitoring patients with knee osteoarthritis undergoing knee arthroplasty, the Timed Up and Go and maximum walking speed tests are commonly used. To provide appropriate peri-surgical rehabilitation, we evaluated the factors associated with postsurgical changes in Timed Up and Go and maximum walking speed results. [Participants and Methods] We enrolled 545 knee osteoarthritis patients undergoing either of the following knee arthroplasties: conventional total knee arthroplasty, minimally invasive total knee arthroplasty, and unicompartmental knee arthroplasty. Comfortable Timed Up and Go, maximum Timed Up and Go, and maximum walking speed were measured 2 weeks before and soon after surgery. Factors (gender, age, and surgical mode) that might influence changes in test results were evaluated by multiple regression analysis and a two-factor stratification diagram. [Results] Multiple regression analysis revealed that postsurgical changes in comfortable/maximum Timed Up and Go and maximum walking speed results were associated with age and surgical mode after adjustment for preoperative values. Two-factor diagrams showed that the older the patient, the greater was the slowdown in the Timed Up and Go test performed postoperatively. The levels of slowdown in the postoperative Timed Up and Go and maximum walking speed tests were the smallest in those who underwent conventional total knee arthroplasty, followed by those who underwent minimally invasive and unicompartmental knee arthroplasty. Among patients whose preoperative Timed Up and Go and maximum walking speed were slow, slowdown in Timed Up and Go was pronounced with age, and slowdown in maximum walking speed was higher in conventional total knee arthroplasty. [Conclusion] The changes in Timed Up and Go and maximum walking speed results 2 weeks after knee arthroplasty depended on age and surgical modes. These findings are relevant for the implementation of appropriate peri-surgical rehabilitation.

Healthcare-seeking behavior and awareness of physical therapy among Japanese residents in Thailand: a descriptive study.

[Purpose] This descriptive study examined healthcare-seeking behavior and awareness of physical therapy among Japanese residents of different age groups in Thailand. [Participants and Methods] The study included 145 Japanese residents in Thailand. An online questionnaire was used to collect data on the participants' sociodemographic characteristics, healthcare-seeking behavior, and awareness of physical therapy. Participants were categorized into three groups based on age, such as young adults, middle-aged adults, and older adults. The χ2 test and Fisher's exact test were used in the data analysis. [Results] The results showed that compared with the older groups, the youngest group was more likely to visit pharmacies, physical therapy clinics, osteopathic clinics, and Thai massage shops to receive healthcare services for injuries or diseases. The participants learned about healthcare services in Thailand through word-of-mouth. Additionally, more than 50% of all participants knew about physical therapy. [Conclusion] There are some differences in health-seeking behavior and awareness of physical therapy among the groups. The youngest group visited physical therapy clinics and 50% of all participants knew about physical therapy.

Quantifying walking ability in Japanese patients with knee osteoarthritis: Standard values derived from a multicenter study.

BACKGROUND: We aimed to determine useful parameters for quantifying walking ability in patients with knee osteoarthritis. METHODS: This study included 621 Japanese patients with knee osteoarthritis scheduled to undergo total knee arthroplasty at any of 14 participating hospitals. Sex, age, body mass index, osteoarthritis severity (Kellgren-Lawrence grade), laterality, prior contralateral surgery, and pain were analyzed for their influence on walking ability, which was evaluated in terms of the 5-m walk test and the Timed Up and Go test outcomes during preoperative hospitalization. Patients were stratified based on dichotomized values of the independent influencing factors of walking ability, and the standard values for parameters describing walking ability were obtained. RESULTS: Multiple regression analysis revealed that sex, age, and Kellgren-Lawrence grade were factors influencing walking ability (5-m walk test and Timed Up and Go test outcomes). Therefore, the patients were stratified by sex, age, and Kellgren-Lawrence grade. The standard values (median values) for walking time on the 5-m walk test among patients aged 60-74/75-89 years were: 3.90/4.64 vs. 4.27/5.12 s for men vs. women with Kellgren-Lawrence grade III; 4.26/5.60 vs. 4.80/6.05 s for men vs. women with Kellgren-Lawrence grade IV. Regarding walking speed on the 5-m test, the standard values were: 1.28/1.08 vs. 1.17/0.98 m/s for men vs. women with Kellgren-Lawrence grade III; 1.17/0.89 vs. 1.04/0.83 m/s for men vs. women with Kellgren-Lawrence grade IV. Finally, the standard values for time on the Timed Up and Go test were: 8.52/10.30 vs. 9.30/11.74 s for men vs. women with Kellgren-Lawrence grade III; 9.40/12.90 vs. 10.05/13.20 s for men vs. women with Kellgren-Lawrence grade IV. CONCLUSIONS: The standard values reported in this study can be used to quantify walking ability decline in patients with knee osteoarthritis and to aid in the decision to consider total knee arthroplasty.

Relationship between Achilles tendon properties and foot strike patterns in long-distance runners.

The purpose of this study was to investigate the relationship between Achilles tendon properties and foot strike patterns in long-distance runners. Forty-one highly trained male long-distance runners participated in this study. Elongation of the Achilles tendon and aponeurosis of the medial gastrocnemius muscle were measured using ultrasonography, while the participants performed ramp isometric plantar flexion up to the voluntary maximum. The relationship between the estimated muscle force and tendon elongation during the ascending phase was fit to a linear regression, the slope of which was defined as stiffness. In addition, the cross-sectional area of the Achilles tendon was measured using ultrasonography. Foot strike patterns (forefoot, midfoot and rearfoot) during running were determined at submaximal velocity (18 km · h(-1)) on a treadmill. The number of each foot strike runner was 12 for the forefoot (29.3%), 12 for the midfoot (29.3%) and 17 for the rearfoot (41.5%). No significant differences were observed in the variables measured for the Achilles tendon among the three groups. These results suggested that the foot strike pattern during running did not affect the morphological or mechanical properties of the Achilles tendon in long-distance runners.

Does self-reported physical activity relate to physical function and walking ability in female patients with hip osteoarthritis? A cross-sectional multicenter study.

BACKGROUND: The effectiveness of a high level of physical activity in maintaining physical function in patients with hip osteoarthritis has not been adequately examined. OBJECTIVE: This study aimed to determine whether self-reported physical activity is associated with physical function and walking ability in female patients with hip osteoarthritis. METHODS: This was a multicenter cross-sectional study. The dependent variables were the lower-limb range of motion and muscle strength, and walking ability. Self-reported physical activity was assessed according to the guidelines of the Japanese Ministry of Health, Labor, and Welfare. Multiple regression models were used to determine whether physical activity was significantly related to the dependent variables after adjusting for confounding factors (age, body mass index, hip pain, comorbidity, and severity of hip osteoarthritis). RESULTS: A total of 167 participants were included in the study. Physical activity was associated with muscle strength in hip flexion (affected/unaffected, ß = 0.18/ß = 0.16), abduction (ß = 0.19/ß = 0.26), knee extension (ß = 0.22/ß = 0.26), Timed Up-and-Go test (ß = -0.16), and 5-m walking time test (ß = -0.15). CONCLUSION: In female patients with hip osteoarthritis, greater physical activity was associated with greater lower extremity muscle strength and walking ability.

Temporal validation of a clinical prediction rule for distinguishing locomotive syndromes in community-dwelling older adults: A cross-sectional study from the DETECt-L study.

Objectives: Clinical prediction rules are used to discriminate patients with locomotive syndrome and may enable early detection. This study aimed to validate the clinical predictive rules for locomotive syndrome in community-dwelling older adults. Methods: We assessed the clinical prediction rules for locomotive syndrome in a cross-sectional setting. The age, sex, and body mass index of participants were recorded. Five physical function tests-grip strength, single-leg standing time, timed up-and-go test, and preferred and maximum walking speeds-were measured as predictive factors. Three previously developed clinical prediction models for determining the severity of locomotive syndrome were assessed using a decision tree analysis. To assess validity, the sensitivity, specificity, likelihood ratio, and post-test probability of the clinical prediction rules were calculated using receiver operating characteristic curve analysis for each model. Results: Overall, 280 older adults were included (240 women; mean age, 74.8 ± 5.2 years), and 232 (82.9%), 68 (24.3%), and 28 (10.0%) participants had locomotive syndrome stages ≥ 1, ≥ 2, and = 3, respectively. The areas under the receiver operating characteristics curves were 0.701, 0.709, and 0.603, in models 1, 2, and 3, respectively. The accuracies of models 1 and 2 were moderate. Conclusions: These findings indicate that the models are reliable for community-dwelling older adults.

Muscles used for chest compression under static and transportation conditions.

BACKGROUND: Unstable conditions during ambulance transportation are not conducive to the performance of high-quality cardiopulmonary resuscitation by emergency medical technicians. OBJECTIVE: The present study was conducted to clarify differences in the quality of chest compression and associated muscle activity between static and ambulance transportation conditions. METHODS: Nine paramedic students performed chest compression for 5 minutes on the floor and during ambulance transportation. Compression rate and depth and success and error rates of chest compression were determined using the Resusci Anne manikin with a PC SkillReporting System (Laerdal Medical). Integrated electromyography (i-EMG) values of eight different muscles were also recorded bilaterally during the first and last 30 seconds of compression. RESULTS: There was no significant difference in compression rate per minute (p = 0.232) and depth of chest compression (p = 0.174) between the two conditions. The success rate was significantly lower under the ambulance transportation condition than under the static condition (p = 0.0161). Compared with those under the static condition, the total i-EMG values were significantly lower for the multifidus (p = 0.0072) and biceps femoris (p < 0.0001) muscles and significantly higher for the deltoid (p = 0.0032), pectoralis major (p = 0.0037), triceps brachii (p = 0.0014), vastus lateralis (p < 0.0001), and gastrocnemius (p = 0.0004) muscles under the ambulance transportation condition. CONCLUSIONS: Chest compression is performed mainly through flexion and extension of the hip joint while kneeling on the floor and through the elbow and shoulder joints while standing in a moving ambulance. Therefore, the low quality of chest compression during ambulance transportation may be attributable to an altered technique of performing the procedure.

Association of sarcopenia, pre-sarcopenia, and dynapenia with the onset and progression of locomotive syndrome in Japanese older adults: a cross-sectional study.

BACKGROUND: Sarcopenia commonly occurs in older adults with motor disorders requiring long-term care, and the clinical features of sarcopenia are associated with locomotive syndrome. Dynapenia is the age-related loss of muscle strength. However, the association of sarcopenia and dynapenia with the onset and progression of locomotive syndrome in older adults remains unknown. The current study aimed to determine the association of sarcopenia, pre-sarcopenia, and dynapenia with the onset and progression of locomotive syndrome in Japanese older adults. METHODS: This study included older females (n = 264, 73.9 ± 5.8 years) and males (n = 92, 76.3 ± 6.1 years). Sarcopenia was defined as low muscle function and mass; pre-sarcopenia was defined as low muscle mass with normal muscle function; and dynapenia was defined as low muscle function without low muscle mass. Locomotive syndrome (stage 0-2) severity was determined using the stand-up test, the two-step test, and the 25-question geriatric locomotive function scale. Logistic regression analysis was performed to determine the relationship between sarcopenia category and locomotive syndrome stages. RESULTS: Age (1.208, 95% confidence interval (CI) 1.124-1.298), sex (2.455, 95% CI 1.241-4.856), and BMI (1.211, 95% CI 1.077-1.361) were significant variables for determining locomotive syndrome stage ≥ 1, whereas pre-sarcopenia (0.543, 95% CI 0.331-0.891) and sarcopenia (1.664, 95% CI 1.005-2.755) were significant variables for determining locomotive syndrome stage 2. CONCLUSIONS: Only sarcopenia was associated with locomotive syndrome progression, while low muscle mass or low muscle function was not associated with locomotive syndrome. Gaining muscle mass accompanied by an increased muscle function for older adults is warranted to prevent locomotive syndrome progression in the super-aged society.

The effects of walking training with poles on walking ability: A systematic review and meta-analysis of randomized controlled trials.

OBJECTIVE: The purpose of this study was to consolidate the level of evidence for the effects of walking training with poles (pole walking; PW) on walking ability using a systematic review and meta-analysis. TYPE: Systematic review and meta-analysis. LITERATURE SURVEY: Databases including PubMed, Cochrane Library, Physiotherapy Evidence Database (PEDro), Cumulative Index to Nursing and Allied Health Literature databases, and Igaku Chuo Zasshi were searched on June 20, 2021. METHODOLOGY: Data from randomized controlled trials (RCTs) comparing the effects of PW with walking without poles and/or other exercise interventions in disease-specific and aging populations were collected. Data on walking speed, functional mobility, and walking endurance were collected for the meta-analyses. Standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated from postintervention means and standard deviations. The PEDro scale was used for assessing the risk of bias, and the Grading of Recommendations Assessment, Development, and Evaluation system was used to determine the quality of evidence. SYNTHESIS: This study included 13 RCTs comprising 750 participants; of these, six RCTs were included in the meta-analysis. The results showed that moderate-quality evidence supports the positive effects of PW on walking speed in patients with Parkinson disease (walking speed: SMD = 0.42, 95% CI = 0.04-0.80). In contrast, PW did not significantly improve functional mobility in patients with Parkinson disease and walking speed in older adults. CONCLUSIONS: There was moderate-quality evidence that PW improved walking speed in patients with Parkinson disease.

The impact of diabetic polyneuropathy on toe grip strength in patients with type 2 diabetes mellitus: a cross-sectional study.

Purpose: Type 2 diabetes mellitus (T2DM) and concomitant diabetic polyneuropathy (DPN) induce muscle weakness. Muscle weakness in the foot is associated with foot deformities and falls. However, factors affecting toe grip strength (TGS) are not well known. Therefore, the present study investigated factors related to TGS in patients with T2DM. Methods: This was a cross-sectional study involving 100 patients with T2DM who were hospitalized for the treatment of T2DM and 50 healthy adults. The subjects were divided into three groups: a group of healthy subjects, a group of T2DM patients without DPN, and a group of T2DM patients with DPN. Hierarchical multiple regression analysis was performed with TGS and the TGS-to-weight ratio (TGS/Wt%) as dependent variables and with age, the presence of T2DM, and DPN as independent variables, and sex and BMI as confounders. Results: There were no significant differences in age or sex among the three groups. In the final regression analysis, age and presence of T2DM and DPN were associated in both models with TGS and TGS/Wt% as dependent variables. Conclusion: DPN, T2DM, and age were found to be related to TGS. The findings of this study could contribute to healthcare providers developing foot care and rehabilitation programs for diabetic patients. Trial registration: This study was registered with UMIN-CTR (UMIN000034320) on 1 November 2018.

Estimation of Reference Values of Gait Spatiotemporal and Kinematic Parameters in the Lower Extremities and Trunk Using a Markerless Motion Capture System for Healthy Older Japanese Adults.

OBJECTIVE: This preliminary study aimed to explore the reference values of spatiotemporal and kinematic parameters in the lower extremities and trunk during gait for the healthy older adults. METHODS: Walking speed, stride length and time, cadence, walk ratio, and step width were calculated as spatiotemporal parameters of gait. Forward tilting of the trunk (FTT), hip flexion and extension, knee flexion and extension, and their laterality were measured as peak angles during one-gait cycle. The bootstrap method was conducted to estimate the 95% confidence interval (CI). RESULTS: This study included 334 healthy older adults (255 women). The following gait parameters were estimated with 95%CI: walking speed (95%CI 1.21-1.30), cadence (95%CI 116.35-121.20), walk ratio (95%CI 0.0055-0.0060), step width (95%CI 0.15-0.17), FTT (95%CI 1.91-4.19), hip flexion (95%CI 28.54-31.01), hip extension (95%CI 19.30-22.27), knee extension (95%CI 0.09-0.14), laterality of hip flexion (95%CI 1.31-2.02), laterality of hip extension (95%CI 1.32-1.97), laterality of knee flexion (95%CI 3.41-4.77), and laterality of knee extension (95%CI 0.07-0.13) in men, and walking speed (95%CI 1.28-1.34), walk ratio (95%CI 0.0050-0.0054), FTT (95%CI 2.54-3.73), hip flexion (95%CI 32.80-34.28), laterality of hip flexion (95%CI 1.65-2.05), laterality of hip extension (95%CI 2.06-2.57), and laterality of knee flexion (95%CI 3.04-3.89) in women. CONCLUSION: This study suggested provisional reference values of spatiotemporal and kinematic parameters in the lower extremities and trunk during gait for the healthy older adults.

Derivation of a clinical prediction rule for chronic post-surgical pain after total knee arthroplasty considering biopsychosocial factors: A prospective cohort study.

BACKGROUND: Biopsychosocial factors are involved in the occurrence of chronic post-surgical pain (CPSP) after total knee arthroplasty (TKA). The purpose of this study was to develop a clinical prediction rule (CPR) that considers biopsychosocial factors to predict which patients are more likely to develop CPSP after TKA. METHODS: CPSP after TKA was dichotomized into CPSP and non-CPSP groups using the Likert scale and Minimal clinically important difference, and binomial logistic regression analysis was performed. Cut-off values were then calculated using the extracted factors and dichotomized variables. The cut-off values and dichotomized variables were then used to derive a CPR that discriminates between groups with and without CPSP. RESULTS: Seventy-one TKA patients were included in the study. Binomial logistic regression analysis revealed that Central Sensitization Inventory (CSI) and Pittsburgh Sleep Quality Index (PSQI) were associated with CPSP. The cut-off values for CSI and PSQI were 26 and 7, respectively. The CPSP scale was created using the cut-off values of CSI and PSQI, with a score of 0 for being below the cut-off values of both CSI and PSQI, 1 for being above the cut-off values of either CSI or PSQI, and 2 for being above the cut-off values of both CSI and PSQI. Furthermore, the area under the curve (AUC) for CPR created by the presence of CPSP and using the CPSP scale was significant (AUC = 0.766; P = 0.001). CONCLUSION: The combination of the two tests, CSI and PSQI, suggested the possibility of predicting CPSP after TKA.

Body Composition Characteristics of Community-Dwelling Older Adults With Dynapenia or Sarcopenia.

This study aimed to determine the differences in muscle and fat masses of the arm and leg between older adults with dynapenia, sarcopenia, or presarcopenia and normal individuals. The percent body fat, lean body mass, and skeletal mass index were measured with bioelectrical impedance analysis. Muscle function was evaluated using grip strength and walking speed. Participants were classified into four categories. Dynapenia was defined as low muscle function with normal muscle mass. Sarcopenia was defined as the presence of both low muscle mass and low muscle function. Presarcopenia was defined as low muscle mass with normal muscle function. Control was defined as normal muscle mass and function. Multivariate analyses of variance were performed separately for women and men to test the main effect of sarcopenia category on body composition. Among the 356 enrolled participants, 270 were women, and 86 were men. In older women, the dynapenia and sarcopenia groups had significantly less muscle mass in the leg than the control group. In older men, the dynapenia group demonstrated a higher body fat mass in the leg than the control group. These results suggest that different strategies are necessary to prevent dynapenia in women and men.

Identifying Target Values of Body Composition for Preventing Frailty: A Descriptive Study in Older Adults.

This study investigated the relationship between frailty and body composition and the target values for preventing frailty in body composition. Frailty status and body composition such as the percent body fat and skeletal mass index was measured. Logistic regression analysis was performed by sex. Receiver operating characteristic curve was used to extract the cutoff values for body composition. The participants were 259 in females and 84 in males for 343 of which 75.5% females. Among the females, age was a significant independent variable. Percent body fat was significantly associated with frailty status in males, with a cutoff value of 27.6%. The area under the curve was significant (0.689, p < 0.01, sensitivity = 0.574, specificity = 0.784). New target value of percent body fat in males for preventing frailty is identified. Findings of this study could contribute to the establishment of preventive intervention for frailty in clinical practice.

Self-reported physical activity is related to knee muscle strength on the unaffected side and walking ability in patients with knee osteoarthritis awaiting total knee arthroplasty: a cross-sectional study.

Background: Additional evidence regarding the effectiveness of self-management programs for patients awaiting total knee arthroplasty is required.Objective: The study aimed to determine if self-reported physical activity was related to muscle strength and walking ability in patients with knee osteoarthritis awaiting total knee arthroplasty.Methods: The study included subjects with knee osteoarthritis awaiting total knee arthroplasty (n = 767). Walking ability and bilateral knee muscle strength were measured as dependent variables. Self-report physical activity was assessed based on the guidelines from the Japanese Ministry of Health, Labor and Welfare. Multiple regression models determined if self-reported physical activity was significantly related to dependent variables, after accounting for other related factors.Results: Physical activity was associated with both higher knee flexion (ß = -0.09, p = .013) and higher extension (ß = -0.09, p = .007) muscle strength on the unaffected side only. In addition, physical inactivity was associated with a lower walking ability level (TUG: ß = 0.08, p = .015; 5mWT: ß = 0.10, p = .005).Conclusions: These results can help health-services providers develop educational and/or self-management programs to maintain muscle strength on the unaffected side and walking ability in patients awaiting total knee arthroplasty.