To determine the accuracy of the 5-time stand-to-sit (5TSTS) test for the identification of older adults with reduced gait speed.
Cross-sectional study.
A total of 559 community-dwelling older adults ...were included in the study, divided into groups of women (n = 465) and men (n = 94).
5TSTS and gait speed were assessed. Multiple linear regression analysis with adjustment was performed in order to determine the association between 5TSTS and gait speed, followed by the receiver operating characteristic (ROC) curve for the identification of the usefulness of 5TSTS to discriminate older adults with reduced gait speed. Based on the ROC curve, we identified the area under the curve, the sensitivity, specificity, and cutoff points of the 5TSST. Statistical analyses were made using the SPSS software (version 25.0), and a significance level of 5% (P ≤ .05) was adopted.
The 5TSTS showed correlation with gait speed. Additionally, 5TSTS was able to discriminate reduced gait speed with moderate accuracy (P < .05; AUC between 0.7 and 0.8). For women, the cutoff scores for 5TSTS to identify gait speed <0.8 m/s was 14.15 seconds; for gait speed <1.0 m/s, it was 12.67 seconds. For men, the cutoff scores for 5TSTS to identify gait speed <0.8 m/s was 14.67 seconds, and for gait speed <1.0 m/s, it was 13.63 seconds.
The 5TSTS is clinically useful and can be an alternative assessment for discriminating community-dwelling older adults with reduced gait speed, when the gait evaluation is not feasible. The study also suggests different cutoff values for 5TSTS considering the gait speeds <0.8 and <1.0 m/s for older women and men, respectively.
Increases in muscular cross-sectional area (CSA) occur in quadriplegics after training, but the effects of neuromuscular electrical stimulation (NMES) along with training are unknown. Thus, we ...addressed two questions: (1) Does NMES during treadmill gait training increase the quadriceps CSA in complete quadriplegics?; and (2) Is treadmill gait training alone enough to observe an increase in CSA? Fifteen quadriplegics were divided into gait (n = 8) and control (n = 7) groups. The gait group performed training with NMES for 6 months twice a week for 20 minutes each time. After 6 months of traditional therapy, the control group received the same gait training protocol but without NMES for an additional 6 months. Axial images of the thigh were acquired at the beginning of the study, at 6 months (for both groups), and at 12 months for the control group to determine the average quadriceps CSA. After 6 months, there was an increase of CSA in the gait group (from 49.8 ± 9.4 cm
2
to 57.3 ± 10.3 cm
2
), but not in the control group (from 43.6 ± 7.6 cm
2
to 41.8 ± 8.4 cm
2
). After another 6 months of gait without NMES in the control group, the CSA did not change (from 41.8 ± 8.4 cm
2
to 41.7 ± 7.9 cm
2
). The increase in quadriceps CSA after gait training in patients with chronic complete quadriplegia appears associated with NMES.
Interdisciplinary Therapy for patients with dementia Cera, Maysa Luchesi; de Abreu, Daniela Cristina Carvalho; Tamanini, Rosângela de Abreu Venancio ...
Dementia & neuropsychologia,
07/2014, Letnik:
8, Številka:
3
Journal Article
Recenzirano
Odprti dostop
Patients with dementia require rehabilitation involving several health professionals, where interdisciplinary care can further enhance the routine of patients and their families.
To compare the ...functional performance of elderly with dementia before and after an interdisciplinary intervention program provided by a healthcare service of medium complexity.
Three cases with clinically-confirmed dementia enrolled on an interdisciplinary rehabilitation program were reported. The following instruments were applied: Mini Mental-State Exam, Clinical Dementia Rating, Geriatric Depression Scale, Lawton & Brody Index, and the Functional Independence Measure for adults (FIM). The therapeutic strategies were individualized and designed based on patient performance on the FIM, according to the criteria of the Classification of Functionality, Disability and Health, implemented at the house of therapy of the Center for Integrated Rehabilitation together with provision of guidance.
A reduction in functional dependence was observed after intervention, evidenced by less supervision needed to carry out Activities of Daily Living.
The three patients benefited from the interdisciplinary intervention.
•Influence of the place of residence on the level of physical activity of the elderly.•Elderly who have lived in rural areas are less sedentary.•Local characteristics influence in the less ...sedentarism between older Women.
The aim of the present study was to investigate levels of physical activity and risk factors for inactivity in older adults living in an urban area in the interior of the Amazonas state, Brazil. Data were collected between 2013 and 2015 from 274 individuals 60 years of age or older who resided in the interior of the Brazilian Amazon. Sociodemographic, general health, functional capacity and physical performance were associated with self-referred physical activity level. A multivariate analysis, after adjustment, showed that being a man, having a body mass index above 27kg/m2, never having lived in riverside communities and having less than three associated chronic diseases were independent risk factors for low levels of physical activity among elderly residing in the interior of the Brazilian Amazon. Few studies have been conducted about the characteristics that are singular to this population. Our results suggest that the physical activity level and, consequently, the aging process of the elderly is influenced by where they have resided throughout their lives. Additionally, the results showed particular risk factors associated with low physical activity level among older adults residing in the interior of the state of Amazonas.
Highlights ► Adolescent with idiopathic scoliosis (AIS) presents deficit of balance. ► Upright balance of AIS was worse than control group. ► After 90 days of corrective spinal surgery, the balance ...deficit of AIS remained. ► Deficit seems to be associated mainly to sensoriomotor impairments.
Despite the well-established role of muscle in maintaining bone mass and physical performance, there are still few studies that assess the relationship between muscle groups and specific bone sites ...and its contribution to physical function in older people. The aim of the study is to verify the association between hip and knee's muscle strength and bone mineral density of the femoral neck (BMD-FN) and investigated which muscle strength that are related with BMD-FN is associated with physical function in older women.
This is a cross-sectional study of 94 women over the age of 60 years, physically independent. Muscle strength of the hip and knee was evaluated using an isokinetic dynamometer (Biodex, USA) to obtain peak torque (PT). The BMD-FN was obtained using dual-energy x-ray absorption densitometry (DXA). Physical function was evaluated by the Timed Up and Go (TUG), gait speed (GS), five times stand to sit (5TSS) and single-leg stance (SS). To verify the association between muscle strength (independent variable) and the BMD-FN (dependent variable) and the relationship between muscle strength (independent variable) and clinical tests (dependent variable), the multiple linear regression was carried out, adjusted for age, time of menopause, height and level of physical activity. All of the analyses were carried out by the SPSS 17.0 software, with a level of p < 0.05 significance.
We found an association between the hip abductors PT and the BMD-FN and between hip abductors PT and all clinical tests.
We observe that hip abductor muscle strength contributes to BMD-FN and to performance in several clinical tests in older women. These findings reinforce the importance of this musculature not only for improving balance and gait, but also it can be a strategy to maintain/improve bone mass in the femoral neck in this population.
Cognitive impairments reduce adaptive responses and may increase the risk of falls.
To compare gait kinematics in older adults with cognitive impairments living in long term institutions and to ...identify the ability of gait kinematics to predict falls in older adults with cognitive impairments living in long term institutions.
Data of 23 older adults with cognitive impairments living in long term institutions were considered for this study. Fifty gait cycles were recorded during walking at a self-selected pace using footswitches sensors. The variables considered for the analysis were: speed; stride length; stance, swing and stride time; and the variability of these parameters. Fall status was recorded for a 6 month-period.
MANOVA found group effect (p = 0.025) for gait kinematics comparisons. Variability of stance (p = 0.01) and swing (p = 0.012) and stride time (p < 0.001) were higher in older fallers. Speed of older fallers was 31.8% slower than those of the non-fallers (p < 0.001). The kinematic variables that were able to predict falls were: stride time variability (p < 0.001), threshold of 0.4 s, sensitivity of 50% and specificity of 100%; and gait speed (p < 0.001), threshold of 0.65 m·s−1, sensibility and specificity of 50%.
Older adults living in an assisted living facility with a history of falls demonstrate increased kinematic variability while walking. However, the ability of gait kinematic parameters to predict falls was found to be weak. The results suggested that gait kinematic parameters are weak predictors of falls in older adults with cognitive impairments living in long term institutions.
•Fallers have increased gait kinematic variability.•The ability of gait kinematics to predict falls had lower sensibility.•Gait kinematics in older fallers and non-fallers are different.
Adapt the 6 minutes walking test (6MWT) to artificial gait in complete spinal cord injured (SCI) patients aided by neuromuscular electrical stimulation.
Nine male individuals with paraplegia (AIS A) ...participated in this study. Lesion levels varied between T4 and T12 and time post injured from 4 to 13 years. Patients performed 6MWT 1 and 6MWT 2. They used neuromuscular electrical stimulation, and were aided by a walker. The differences between two 6MWT were assessed by using a paired t test. Multiple r-squared was also calculated.
The 6MWT 1 and 6MWT 2 were not statistically different for heart rate, distance, mean speed and blood pressure. Multiple r-squared (r2 = 0.96) explained 96% of the variation in the distance walked.
The use of 6MWT in artificial gait towards assessing exercise walking capacity is reproducible and easy to apply. It can be used to assess SCI artificial gait clinical performance.
Summary We evaluate the effects of somatosensory training on the mean amplitude of the center of pressure (COP) in the upright position and the sustained benefits after 6-month. Twelve elderly ...patients with type II diabetes (T2DM) participated in the study. Patients with T2DM were allocated to the somatosensory protocol, which consisted of a circuit composed of 13 stations with different textures. The rehabilitation protocol was applied twice a week during the period of 12 weeks. Upright balance, in 2 situations (fixed platform with eyes open and closed) to evaluate the mean amplitude of COP oscillation in the anterior-posterior and medial-lateral directions and the total area of COP oscillation. Outcomes were assessed at baseline, post-exercise and 6-month follow-up. The somatosensory training protocol was beneficial to reduce the AP oscillation of the COP, remaining after 6 months of the end of intervention in elderly with T2DM.
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