The aim of this study was to evaluate functional independence and trunk control during maximum-range tasks in individuals with spinal cord injuries, who were divided into sedentary (SSI, n=10) and ...physically active (PASI, n=10) groups .
Anamnesis was conducted and level and type of injury were identified (according to the American Spinal Injury Association protocol, ASIA) and the Functional Independence Measure (FIM) questionnaire was applied. For the forward and lateral reach task, the subjects were instructed to reach as far as possible. Mean data were compared using the unpaired t test and Mann-Whitney test and differences were considered significant when p<0.05 .
The PASI group performed better in self-care activities (PASI: 40.8±0.42 points, SSI: 38.0±3.58 points, p=0.01), sphincter control (PASI: 10.5±1.84 points, SSI: 8.2±3.04 points, p=0.02), transfers (PASI: 20.7±0.48 points, SSI: 16.9±4.27 points, p=0.04), and total FIM score (PASI: 104.0±2.30 points, SSI 105.1±8.56 points, p=0.01). On the maximum reach task, the PASI group had a greater average range in all directions evaluated (p<0.05) .
The continuous practice of exercise increased motor function independence and trunk control in individuals with complete spinal cord injury. Level of Evidence II, Prospective Comparative Study.
White matter damage quantified as white matter hyperintensities (WMH) may aggravate cognitive and motor impairments, but whether and how WMH burden impacts these problems in Parkinson’s disease (PD) ...is not fully understood. This study aimed to examine the association between WMH and cognitive and motor performance in PD through a systematic review and meta-analysis. We compared the WMH burden across the cognitive spectrum (cognitively normal, mild cognitive impairment, dementia) in PD including controls. Motor signs were compared in PD with low/negative and high/positive WMH burden. We compared baseline WMH burden of PD who did and did not convert to MCI or dementia. MEDLINE and EMBASE databases were used to conduct the literature search resulting in 50 studies included for data extraction. Increased WMH burden was found in individuals with PD compared with individuals without PD (i.e. control) and across the cognitive spectrum in PD (i.e. PD, PD-MCI, PDD). Individuals with PD with high/positive WMH burden had worse global cognition, executive function, and attention. Similarly, PD with high/positive WMH presented worse motor signs compared with individuals presenting low/negative WMH burden. Only three longitudinal studies were retrieved from our search and they showed that PD who converted to MCI or dementia, did not have significantly higher WMH burden at baseline, although no data was provided on WMH burden changes during the follow up. We conclude, based on cross-sectional studies, that WMH burden appears to increase with PD worse cognitive and motor status in PD.
•WMH burden seems to be involved in the transition to dementia in PD.•Worse executive function, attention, and language performance were associated with increased WMH burden in PD.•Increased WMH burden seems to aggravate global motor symptoms.•Confirmation of the WMH burden in the transition from normal cognition to MCI or dementia in PD is still necessary.
Aim
A number of studies have explored possible relationships, behavior, and meanings of spatial and temporal gait variables in frail and pre‐frail older adults, particularly the gait speed variable. ...However, it is necessary to know the relationship of other spatial and temporal gait variables of pre‐frail older adults. Thus, the objective of the present study was to evaluate and compare gait standards between pre‐frail and non‐frail older people.
Methods
A total of 69 older adults aged 60 year and older, divided into two groups, non‐frail (n = 42) and pre‐frail (n = 27), were evaluated. Gait parameters were analyzed using the GAITRite® Platinum 26′ Portable Walkway System.
Results
Pre‐frail older people had smaller step lengths (P = 0.041), larger base of support (P = 0.040), lower speed (P = 0.019), lower single support percentage (P = 0.033) and higher double support percentage (P = 0.036), compared with non‐frail older people. A history of falls was correlated to lower gait speed and step length in pre‐frail older adults.
Conclusions
Identifying pre‐frail older people could have significant clinical consequences, as frailty is a dynamic process, and such individuals can therefore progress into a state of frailty or revert to a non‐frail state. Therefore, the identification of gait variables in pre‐frail older people can be an important tool to recognize gait deficits and to initiate the appropriate treatment. Geriatr Gerontol Int 2016; 16: 1102–1108.
Abstract Objectives To assess balance and function of symptomatic and asymptomatic subjects with knee osteoarthritis (OA) and investigate the influence of physical exercise. Design Subjects were ...divided into three groups: Group 1 (n = 15), symptomatic knee OA; Group 2 (n = 11), asymptomatic knee OA; and Group 3 (n = 16), knee OA and no intervention. History of falls, the WOMAC questionnaire, balance and functionality were assessed. Results After intervention, there was a significant difference in the total WOMAC score and in the pain and function domains only in Group 1. After intervention, Group 2 showed significant differences in decreased time on the Step Up/Over test and postural sway increased. Conclusion After the intervention, the symptomatic group reported improvement in pain and function on the WOMAC, while the asymptomatic group showed improvement in performance in the Step Up/Over test. There were no new episodes of falls in groups 1 and 2.
With the increase in the percentage of the population in older adulthood, issues such as frailty syndrome need to be considered. The aim of the present study was to evaluate the ability of the ...Balance Evaluation Systems Test (BESTest) and center of pressure (COP) in their ability to discriminate between nonfrail, prefrail, and frail older adults. The proposed hypothesis is that frail older adults would show poorer performance in BESTest tasks and higher oscillation of COP on a force platform.
Sixty older adults 65 years or older were divided into 3 groups of 20: group 1, nonfrail; group 2, prefrail; and group 3, frail. The prefrail and frail identifications were made by Fried's 5 frailty phenotype criteria. Balance was assessed using the BESTest and a force platform in 6 positions: (1) fixed platform with eyes open; (2) fixed platform with eyes closed; (3) unstable platform with foam, with eyes open; (4) unstable platform, with eyes closed; (5) semitandem with eyes open; and (6) semitandem with eyes closed.
Frail older adults had lower scores in all sections and in the total score of the BESTest, indicating worse performance in the tasks. However, on the force platform, the frail older adults did not show higher oscillations, having similar mean values when compared with the prefrail and nonfrail older adults, indicating similar behavior of COP.
The BESTest seems to be more appropriate than a force plate for assessing postural control impairment and discriminating balance performance among frail, prefrail, and nonfrail older adults, providing information about different components of postural control rather than the force plate, which evaluates sensory orientation.
The symptoms associated with chronic peripheral vestibulopathy exert a negative impact on the independence and quality of life of these individuals, and many individuals continue to suffer from these ...symptoms even after conventional vestibular rehabilitation.
To evaluate the acute effect of an anchor system for balance evaluation of patients with chronic dizziness who failed to respond to traditional vestibular rehabilitation.
Subjects over 50 years of age, presenting with chronic dizziness and postural instability of peripheral vestibular origin, participated in the study. The limit of stability was evaluated in three positions using the Balance Master® system: Position 1, standing with the arms along the body; Position 2, standing with the elbows bent at 90° (simulating holding the anchors); and Position 3, with the elbows bent at 90° holding the anchors. The variables of movement latency, endpoint excursion and directional control of movement were evaluated.
Using the anchor system, significant reduction of time in the response at the beginning of the movement compared to Position 1 (p<0.05); increased endpoint excursion in the left lateral direction compared to Position 1 (p<0.05); and more directional control of movement in the anterior and posterior directions (p<0.05) compared to the other positions, were found.
While using the system anchor, individuals with chronic peripheral vestibulopathy showed an immediate improvement in the stability limit in relation to the movement latency, endpoint excursion, and directional control of movement variables, suggesting that the haptic information aids postural control.
Os sintomas associados à vestibulopatia periférica crônica têm impacto negativo na independência e qualidade de vida dos indivíduos, e muitos deles continuam a sofrer desses sintomas, mesmo depois de terem passado pela reabilitação vestibular convencional.
Avaliar o efeito agudo de um sistema de ancoragem para avaliação do equilíbrio de pacientes com tontura crônica que não responderam à reabilitação vestibular tradicional.
Indivíduos com mais de 50 anos que se apresentaram com tontura crônica e instabilidade postural de origem vestibular periférica participaram no estudo. O limite de estabilidade foi avaliado em três posições, com o uso do sistema Balance Master®: Posição 1, de pé com os braços pendentes ao longo do corpo; Posição 2, de pé com os cotovelos flexionados em 90° (simulando a posição de segurar as âncoras); e Posição 3, com os cotovelos flexionados em 90° e segurando as âncoras. Foram avaliadas as variáveis de latência de movimento, ponto final da excursão e controle direcional do movimento.
Com o uso do sistema de âncoras, ocorreu redução significante no tempo de resposta no início do movimento em comparação com a Posição 1 (p<0,05); aumento no ponto final da excursão na direção lateral esquerda, em comparação com a Posição 1 (p<0,05); e mais controle direcional do movimento nas direções anterior e posterior (p<0,05), em comparação com as demais posições.
Enquanto usavam o sistema de âncoras, os indivíduos com vestibulopatia periférica demonstraram melhora imediata no limite da estabilidade em relação às variáveis latência de movimento, ponto final da excursão e controle direcional do movimento, sugerindo que a informação háptica auxilia no controle postural.
Background
Despite the clinical importance, it has remained unclear which changes in the trunk muscle function parameters are more associated with the presence of vertebral fracture (VF).
Aims
The ...aim of this study was to verify the association between the trunk muscle function performance and the presence of VF in older women with low bone mass. The secondary aim was to evaluate the correlation between trunk muscle function and both fall history and muscle mass.
Methods
This cross-sectional study was composed by 94 women over 60 years within value of
T
-Score lumbar spine BMD <− 1.0 DP. Multidimensional evaluations were performed: appendicular skeletal muscle mass index (ASMI) was determined by the total body DEXA; the radiographic evaluations measured the degree of thoracic kyphosis and classification of VF. The trunk muscle function parameters, such as peak torque (PT), rate of torque development (RTD) and torque steadiness (TS) were evaluated by isokinetic dynamometer. The trunk muscle endurance was evaluated by the timed loaded standing test. The adjusted multivariate logistic regression model and multivariate linear regression were performed to verify the association between the variables studied.
Results
The results showed that the trunk muscle function parameter with greater association with the presence of VF is TS extensors (OR = 1.70;
p
< 0.001). The other two significant muscle parameters were: RTD
30
flexors (OR = 0.31;
p
= 0.033) and PT extensors (OR = 0.13;
p
= 0.009). No statistical association was found between the presence of VF and the ASMI and trunk muscle endurance. No correlation between trunk muscle function and fall history was observed. There was a weak correlation between ASMI and extensor PT (
R
2
= 0.21;
p
= 0.027) and extensor RTD
30
(
R
2
= 0.21;
p
= 0.026).
Conclusions
This study demonstrated that deficit in trunk muscle function has shown a strong association with the presence of VF, highlighting issues heretofore unexplored regarding the association between VF with muscle power and motor control.
Abstract
Introduction
Peripheral vestibular disorders can lead to cognitive deficits and are more common in elderly patients.
Objective
To evaluate and correlate cognitive, balance and gait aspects ...in elderly women with chronic peripheral vestibular dizziness, and to compare them with elderly women without vestibular disorders.
Methods
Twenty-two women presenting peripheral vestibular dizziness episodes for at least six months participated in the study. The individuals were categorized by dizziness severity level: moderate (
n
= 11) or severe (
n
= 11). The control group (
n
= 11) included women showing no vestibulopathy, light-headedness or dizziness. Cognitive assessments and semi-static and dynamic balance assessments were performed with the Balance Master (Neurocom International, Inc., Clackamas, OR), while the Dizziness Handicap Inventory provided a score for the severity of the symptoms. The groups were submitted to statistics of inference and correlation between cognitive, balance and stability variables.
Results
The group with severe dizziness showed higher sway speed of the center of pressure in the anteroposterior direction, smaller step length, and slower gait than the control group. Regarding the cognitive variables, the group with severe dizziness symptoms presented significant correlations with stability and gait variables.
Conclusion
The relationship between cognitive aspects, balance and gait was stronger in women with severe dizziness than in those with no vestibulopathy.
Rheumatoid arthritis (RA) is a systemic inflammatory and
chronic
disease of joints, which may result in irreversible deformities. To evaluate the effects of an exercise programme aimed at improving ...the hand strength in individuals with hand deformities resulting from RA and to analyse the impact these exercises have on functionality. Twenty women with RA hand deformities participated in the study. They were randomly divided into two groups as follows: Group 1 (
n
= 13) had women participating in the exercise programme aimed at improving handgrip (HS) and pinch strengths (PS) as well as the motor coordination of the hand; Group 2 (
n
= 7) had women with RA who received no treatment for their hands (control). The treatment programme for hands consisted of 20 sessions, twice a week and at-home exercises. Both groups were submitted to Health Assessment Questionnaire (HAQ) and evaluation of HS and PS by means of dynamometry. Re-evaluations were performed after 10 and 20 sessions in Group 1 and after 2 months in Group 2. After 20 sessions of physiotherapy, Group 1 had a significant gain in HS and PS (
p
< 0.05) in addition to the improvement of functionality as assessed by HAQ (
p
= 0.016). For Group 2, no difference was found between the variables analysed (
p
> 0.05). The strengthening exercises for individuals with RA hand deformity are beneficial to improve handgrip and pinch strengths as well as functionality.
The objective of this study was to compare the functional performance of community-dwelling older adults of both sexes and investigate the possible mediation aspects that may influence the sex ...differences regarding socioeconomic and anthropometric characteristics, health status, and quadriceps muscle strength. 233 Brazilian older adults were assessed, and men's and women's sociodemographic data, physical activity level, quadriceps muscle strength, functional performance (gait speed and the SPPB), and history of falls were compared. Sex differences in functional performance were observed even after statistically adjusting the model (age, body mass, income, physical activity level, and occurrence of falls). When quadriceps muscle strength was included in the adjusted model, the sex difference remained only for gait speed. When stature was included in the adjusted model, the sex difference in gait speed disappeared. Our results suggest that the sex difference in functional performance assessed by the SPPB can be explained due to the fact that men are stronger than women. In addition, the sex difference regarding gait speed was explained by the sex difference in stature. Public actions that encourage older women to practice physical activities that promote increased muscle strength can positively interfere with their best functional performance for as long as possible.
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