Abstract
Objectives
Fear of falling (FoF) is common in older adults. Physical activity decreases as FoF increases. However, this association between physical activity and FoF may vary depending on ...activity intensity. The current study was performed to explore the associations between FoF and step count, light-intensity physical activity (LPA), and moderate/vigorous-intensity physical activity (MVPA) in community-dwelling older adults.
Methods
This cross-sectional observational study was held at a local community association center, with 242 older adults living independently in the community (mean age: 75.1 ± 5.4 years). FoF was defined using the Falls Efficacy Scale-International and categorized into three levels (low, moderate, and high). Physical activity was measured using a uniaxial accelerometer worn for 7 consecutive days, and by calculating daily step count, LPA, and MVPA, over this period.
Results
Step count and physical activity intensity showed significant linear trends across FoF severity (p < .01, respectively). High FoF decreased step count by approximately 2,000 steps/day. Further, high FoF was significantly associated with short durations of both LPA and MVPA. In addition, moderate FoF was associated with decreased LPA duration, even after adjustment for confounding variables.
Discussion
Physical activity decreased concomitantly with a rise in FoF severity. Moreover, the association between physical activity and FoF differed by physical activity intensity level in community-dwelling older adults. Further studies are needed to investigate the causal relationship between FoF and objective physical activity in this population.
We developed a novel quantitative method to assess varus thrust during walking using acceleration data obtained from an inertial measurement unit (IMU). This study aimed to examine the reliability of ...the developed index and to evaluate its ability to distinguish patients with knee osteoarthritis (OA) with varus thrust from healthy adults. Overall, 16 patients with knee OA and 16 healthy adults walked on a treadmill with IMUs attached to the tibial tuberosity and lateral femoral condyle. As an index of varus thrust, we used the root mean square (RMS) of acceleration in the mediolateral direction. This value was adjusted by dividing it by swing speed while walking (adjusted RMS, A-RMS) because the RMS of the acceleration was strongly coupled with the speed of motion. The intraclass correlation coefficients of A-RMS of the tibia and femur were 0.85 and 0.73, respectively. Significant differences were observed in the A-RMSs of the tibia and femur, with large effect sizes between the patients with knee OA and healthy adults (Cohen’s d: 1.23 and 0.97, respectively). Our results indicate that A-RMS has good test–retest reproducibility and can differentiate patients with varus thrust from healthy adults.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
•Patients with knee osteoarthritis experience trunk movement asymmetry during gait.•We assessed trunk movement asymmetry before and after surgery via accelerometry.•Medio-lateral and antero-posterior ...asymmetries decreased after surgery.•Decreases in quadriceps strength and trunk movement asymmetries are correlated.
Patients with knee osteoarthritis (OA) demonstrate trunk movement asymmetry during walking; this asymmetry is associated with disability and quadriceps strength asymmetry.
What are the differences between trunk movement asymmetries before and after total knee arthroplasty (TKA) and associations between the changes in trunk movement asymmetry and quadriceps strength asymmetry?
In this prospective cohort study, 27 patients (mean age, 71.0 years; women, 85.2%) were assessed at 1 month before and 6 months after surgery. Trunk movement asymmetry (harmonic ratio) was assessed at their preferred pace using a triaxial accelerometer. The isometric quadriceps strength was evaluated using a hand-held dynamometer, and the quadriceps strength inter-limb absolute difference was calculated. Multivariate analyses were performed to compare the trunk movement asymmetries before and after surgery with covariate adjustment (gait pain, gait velocity, and non-operated-limb Kellgren and Lawrence K&L grade) and to investigate the association between the changes in trunk movement asymmetry and quadriceps strength inter-limb difference with covariate adjustment (age, sex, and non-operated-limb K&L grade).
The trunk movement asymmetry in the medio-lateral (mean difference, 0.61; 95% confidence interval CI, 0.22 to 1.00) and antero-posterior (mean difference, 1.15; 95% CI, 0.48 to 1.83) directions significantly decreased postoperatively compared with the preoperative results. A decreased quadriceps strength inter-limb difference was significantly associated with a decreased medio-lateral trunk movement asymmetry (β = 0.68; 95% CI, 0.30 to 1.06).
TKA plays an important role in the improvement of trunk stability during walking in patients with knee OA. Decreasing quadriceps strength asymmetry may be a key to improving trunk movement asymmetry.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Introduction/Aims
Attenuation of the ultrasound (US) wave is a serious limitation of echo intensity (EI) on B‐mode US. The aim of this study was to determine whether the focus depth of US images ...influences the depth‐dependent attenuation of EI and the relationship between EI and intramuscular adipose tissues (IntraMAT).
Methods
The rectus femoris (RF) and vastus intermedius (VI) of the right thigh were studied in 135 adults (92 older, 43 younger). The EI on US images was measured at three focus depth conditions: top of the image, center of the RF, and center of the VI. The depth of the region of interest (ROI) was measured. IntraMAT was calculated using water and fat images based on the two‐point Dixon technique with a 3.0‐T magnetic resonance imaging scanner.
Results
The correlation between EI and IntraMAT was stronger in the focus RF and VI conditions than in the focus top condition and stronger for RF than for VI. The depth of the ROI influenced the IntraMAT‐adjusted residual EI more in the focus top condition than in the focus RF and VI conditions, and influenced VI more strongly than it did RF.
Discussion
By mitigating EI attenuation, EI with a focus depth adjusted to the ROI reflected IntraMAT more accurately than that without adjustment. However, it may not completely prevent the potential influence of depth‐dependent attenuation of EI, especially for deeper muscles such as the VI.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
This study aimed to assess the association between the degree of varus thrust (VT) assessed by an inertial measurement unit (IMU) and patient-reported outcome measures (PROMs) in patients with knee ...osteoarthritis. Seventy patients (mean age: 59.8 ± 8.6 years; women: n = 40) were instructed to walk on a treadmill with an IMU attached to the tibial tuberosity. For the index of VT during walking (VT-index), the swing-speed adjusted root mean square of acceleration in the mediolateral direction was calculated. As the PROMs, the Knee Injury and Osteoarthritis Outcome Score were used. Data on age, sex, body mass index, static alignment, central sensitization, and gait speed were collected as potential confounders. After adjusting for potential confounders, multiple linear regression analysis revealed that the VT-index was significantly associated with the pain score (standardized β = -0.295;
= 0.026), symptoms score (standardized β = -0.287;
= 0.026), and activities of the daily living score (standardized β = -0.256;
= 0.028). Our results indicated that larger VT values during gait are associated with worse PROMs, suggesting that an intervention to reduce VT might be an option for clinicians trying to improve PROMs.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Background
Fear of falling (FoF) is a common psychological problem in community-dwelling older adults. However, which mobility function relate to newly developed FoF and persistent FoF are unknown.
...Aims
We aimed to clarify which baseline mobility function is an independent predictor of one-year change in FoF.
Methods
The study design was a one-year longitudinal predictive validity study. Participants were 581 independently community-dwelling older adults without neurological disorders. We measured FoF, history of falls, inactive lifestyle, and sociodemographic data were obtained via a self-administered questionnaire. Mobility functions were measured by community-based Short Physical Performance Battery (SPPB-com).
Results
Newly developed FoF group accounted for 20% among the non-FoF older adults at baseline. Persistent FoF group accounted for 57% among the older adults with FoF at baseline. Risk of newly developed FoF was significantly related to the SPPB-com total score, among the mobility functions, the low gait test score (OR 95% CI = 2.34 1.12–5.12) and the low tandem balance test score (OR 95% CI = 3.62 1.46–8.90) were significantly related. Risk of persistent FoF was also related to SPPB-com total score, among the mobility functions, the five chair stand test score (OR 95% CI = 1.96 1.19–3.24) was significantly related.
Discussion and conclusion
The risk of newly developed FoF related to lower ability of standing-balance and gait, the risk of persistent FoF related to lower sit-to-stand ability. Appropriate exercise interventions according to FoF subtype may effectively prevent the risk of developing FoF or experiencing persistent FoF.
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EMUNI, FZAB, GEOZS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
This study compared the muscle thickness (MT) and echo intensity (EI) of the abdominal, thigh, and lower leg muscles between the paretic and nonparetic sides in chronic stroke survivors.
Thirty-two ...stroke survivors living in the community participated in this study. The MT and EI, which are indicators of muscle mass and intramuscular fat or connective tissue, were assessed in the rectus abdominis, external oblique, internal oblique, transversus abdominis, rectus femoris, vastus intermedius, vastus lateralis, vastus medialis, tibialis anterior, gastrocnemius, and soleus via transverse ultrasound imaging. In addition, a possible indicator of physical activity-the frequency of going out per week-was evaluated.
All quadriceps muscles and the tibialis anterior were significantly thinner and the EI values of the vastus intermedius, vastus lateralis, vastus medialis, and soleus were significantly higher in the paretic limb than the nonparetic limb. The MT and EI values of abdominal muscles did not differ significantly between the two sides. The MT values of the paretic rectus femoris, vastus lateralis, and vastus medialis were significantly associated with the frequency of going out after adjusting confounding factors. The MT of the nonparetic vastus lateralis was significantly associated with latency from stroke onset after adjusting confounding factors.
Our results indicate that quantitative and qualitative changes on the paretic side in stroke survivors were the most robust in the thigh muscles, whereas such changes might not occur in the abdominal muscles.
Muscle damage and loss of muscle mass are triggered by immobilization, loss of appetite, dystrophies and chronic wasting diseases. In addition, physical exercise causes muscle damage. In damaged ...muscle, the N-terminal and C-terminal regions of titin, a giant sarcomere protein, are cleaved by calpain-3, and the resulting fragments are excreted into the urine via glomerular filtration. Therefore, we considered titin fragments as promising candidates for reliable and non-invasive biomarkers of muscle injury. Here, we established a sandwich ELISA that can measure the titin N-terminal fragment over a biologically relevant range of concentrations, including those in urine samples from older, non-ambulatory Duchenne muscular dystrophy patients and from healthy donors under everyday life conditions and after exercise. Our results indicate that the established ELISA could be a useful tool for the screening of muscular dystrophies and also for monitoring the progression of muscle disease, evaluating the efficacy of therapeutic approaches, and investigating exercise-related sarcomeric disruption and repair processes.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Both multiple fall experiences and fear of falling (FoF) would make people susceptible to another fall; however, the associations are unknown. This study investigates the association of FoF with fall ...occurrence among older adults according to their fall history.
In this study, we adopted a longitudinal observational design. We visited 20 community centers to recruit 1,025 older adults (aged 65 years or older). At baseline, FoF was assessed using a single-item questionnaire. The number of falls in the past year was obtained via a self-questionnaire and participants were classified into three fall history groups (0: non-faller, 1: single faller, 2 or more: multiple faller). After a year of following-up, the number of falls during the year was considered as the main outcome. Poisson regression models clarified the influence of FoF on fall occurrence during the one-year follow-up, according to the participants' fall history.
The final sample comprised 530 individuals (follow-up rate: 530/801, 66.4%). Fall history, FoF, and interaction between multiple fallers and FoF were significant in the adjusted statistical model (rate ratio 95% confidence interval: single faller = 2.81 1.06, 6.30, multiple faller = 13.60 8.00, 23.04, FoF = 3.70 2.48, 5.67, multiple faller*FoF = 0.37 0.20, 0.68).
We found that FoF was associated with the occurrence of falls in community-dwelling older adults. However, its association was lower in multiple fallers.
Purpose In this study, we verified the validity of the step time and walking speed obtained from the smartphone gait analysis application CareCoaching. Participants and Methods The participants were ...66 independent, community-dwelling adults aged 65 years or older who performed a 10-m walking test twice each under preferred- and slow-speed conditions. We concurrently measured gait motions using CareCoaching and the OptoGait system for reference data. Both systems compute walking speed and step time as gait parameters. We examined the concurrent validity of these parameters by using intra-class correlation coefficients (ICCs) and limits of agreement (LOAs) with Bland−Altman analyses. Results In the preferred walking speed condition, the ICCs of walking speed and step times between the CareCoaching and the OptoGait system were 0.67 and 0.93, respectively. In the slow walking speed condition, the ICCs for walking speed and step time were 0.78 and 0.97, respectively. In addition, the LOAs for step time were −0.0941 to 0.1160 for preferred walking speed and −0.0596 to 0.0883 for slow walking speed. The LOAs for walking speed were −0.4158 to 0.0568 for preferred walking speed and −0.3348 to 0.0523 for slow walking speed. Conclusion CareCoaching showed excellent agreement for step time and moderate-to-good agreement for walking speed in independent, community-dwelling older adults.
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