A claims-based frailty index (CFI) was developed based on a deficit-accumulation approach using self-reported health information. This study aimed to independently validate the CFI against physical ...performance and adverse health outcomes.
This retrospective cohort study included 3,642 community-dwelling older adults who had at least 1 health care encounter in the year prior to assessments of physical performance in the 2008 Health and Retirement Study wave. A CFI was estimated from Medicare claims data in the past year. Gait speed, grip strength, and the 2-year risk of death, institutionalization, disability, hospitalization, and prolonged (>30 days) skilled nursing facility (SNF) stay were evaluated for CFI categories (robust: <0.15, prefrail: 0.15-0.24, mildly frail: 0.25-0.34, moderate-to-severely frail: ≥0.35).
The prevalence of robust, prefrail, mildly frail, and moderate-to-severely frail state was 52.7%, 38.0%, 7.1%, and 2.2%, respectively. Individuals with higher CFI had lower mean gait speed (moderate-to-severely frail vs robust: 0.39 vs 0.78 m/s) and weaker grip strength (19.8 vs 28.5 kg). Higher CFI was associated with death (moderate-to-severely frail vs robust: 46% vs 7%), institutionalization (21% vs 5%), activity of daily living disability (33% vs 9%), instrumental activity of daily living disability (100% vs 22%), hospitalization (79% vs 23%), and prolonged SNF stay (17% vs 2%). The odds ratios per 1-SD (=0.07) difference in CFI were 1.46-2.06 for these outcomes, which remained statistically significant after adjustment for age, sex, and a comorbidity index.
The CFI is useful to identify individuals with poor physical function and at greater risks of adverse health outcomes in Medicare data.
•The study compared six frailty tools in older hypertensive outpatients.•Frailty predicted 1-year functional decline, independently of baseline function and comorbidities.•The CFS (score ≥4) ...predicted 1-year decline with 91 % negative predictive value.•CFS may help identify non-frail hypertensive patients at low risk of functional decline.
Few studies have evaluated frailty in older hypertensive individuals and the most appropriate tools to identify frailty in this population have yet to be identified. This study compared the performance of six frailty instruments in the prediction of 1-year functional decline in older hypertensive outpatients.
The HYPERtension and FRAILty in Older Adults (HYPER-FRAIL) longitudinal pilot study involved hypertensive participants ≥75 years from two geriatric outpatient clinics at Careggi Hospital, Florence, Italy, undergoing identification of frailty with four frailty scales (Fried Frailty Phenotype, Frailty Index FI, Clinical Frailty Scale CFS, Frailty Postal Score) and two physical performance tests (Short Physical Performance Battery SPPB and gait speed). Prediction of 1-year functional decline (i.e. a ≥ 10-point Barthel Index decrease between baseline and follow-up) was examined based on ROC curve analysis and multivariable logistic regression.
Among 116 participants, 24 % reported functional decline. In the ROC curve analyses, FI (AUC=0.76), CFS (AUC=0.77), gait speed (AUC=0.73) and the SPPB (AUC=0.77) achieved the best predictive performance, with FI ≥0.21 and CFS ≥4 showing the highest sensitivity (82 %) and negative predictive value (91 %). Frailty identified with FI, CFS or physical performance tests was associated with an increased risk of 1-year functional decline, independently of baseline functional status and comorbidity burden.
FI, CFS and physical performance tests showed similar predictive ability for functional decline in hypertensive outpatients. The CFS and gait speed might be more suitable for clinical use and may be useful to identify non-frail individuals at lower risk of functional decline.
In 2018, the European Working Group on Sarcopenia in Older People (EWGSOP) updated the definition and the diagnosis criteria of sarcopenia. Previous systematic reviews have shown the effect of ...exercise on sarcopenia including people with different sarcopenia diagnostic criteria.
This systematic review and meta-analysis aims to summarise and synthesise the evidence about the effect of exercise on muscle mass, strength and physical performance in older adults with sarcopenia according to the EWGSOP criteria.
Major electronic databases were searched for articles published until September 2020. Randomised controlled trials (RCTs) and non-randomised interventional studies examining the effect of exercise on muscle mass, strength or physical performance in adults older than 60 years with sarcopenia according to the EWGSOP criteria were included.
Four RCTs and three non-randomised interventional studies with a total of 235 patients with sarcopenia were included. Five of the seven included studies reported a low risk of bias. Exercise showed a large effect on physical performance (d = 1.21, 95%CI 0.79 to 1.62; P < 0.001), a medium effect on muscle strength (d = 0.51, 95%CI 0.25 to 0.76; P < 0.001), and no effect on muscle mass (d = 0.27, 95%CI −0.05 to 0.58; P = 0.10).
The present systematic review showed an effect of exercise on physical performance and muscle strength but an inconsistent effect on muscle mass. The grading of recommendations assessment, development and evaluation criteria showed a low level of evidence in muscle mass, a low or moderate level of evidence in muscle strength and a high level of evidence in physical performance.
•Sarcopenia is considered one of the main causes of disability in older adults.•The EWGSOP defined sarcopenia as a decreased muscle mass together with low muscle strength and low physical performance.•Exercise reported a large effect on physical performance and a medium effect on muscle strength.•Exercise showed an inconsistent effect on muscle mass, which was a non-significant small effect.•The risk of bias was low. The evidence was low in muscle mass, moderate in muscle strength and high in physical performance.
The purpose of this investigation was to analyse the concurrent validity and reliability of an iPhone app (called: My Jump) for measuring vertical jump performance. Twenty recreationally active ...healthy men (age: 22.1 ± 3.6 years) completed five maximal countermovement jumps, which were evaluated using a force platform (time in the air method) and a specially designed iPhone app. My jump was developed to calculate the jump height from flight time using the high-speed video recording facility on the iPhone 5 s. Jump heights of the 100 jumps measured, for both devices, were compared using the intraclass correlation coefficient, Pearson product moment correlation coefficient (r), Cronbach's alpha (α), coefficient of variation and Bland-Altman plots. There was almost perfect agreement between the force platform and My Jump for the countermovement jump height (intraclass correlation coefficient = 0.997, P < 0.001; Bland-Altman bias = 1.1 ± 0.5 cm, P < 0.001). In comparison with the force platform, My Jump showed good validity for the CMJ height (r = 0.995, P < 0.001). The results of the present study showed that CMJ height can be easily, accurately and reliably evaluated using a specially developed iPhone 5 s app.
INTRODUCTION: The human gut microbiota is an extremely diverse and complex ecosystem that inhibits the mucous membranes of the intestines. It is probable that the microbiota, with its capacity to ...influence the immune system and establish the conditions required for metabolic and structural functions essential for maintaining homeostasis, may significantly affect the health, well-being, and performance of athletes. PURPOSE: The aim of the study is to present the current state of knowledge about the differences in athletes’ gut microbiota, how these changes affect their physical performance and uncover the mechanisms behind gut microbiota and probiotics in physical performance among population of athletes. MATERIAL AND METHODS: The following review was conducted using the articles from the Pubmed and Google Scholar databases, employing keywords related to gut microbiota, athletes, physical performance. We collected studies performed on populations of athletes, exploring different sport disciplines. CONCLUSIONS: Numerous studies have investigated the gut microbiota of athletes, emphasizing the impact of both training and diet. Athletes' unique dietary regimens, including higher protein or carbohydrates intake, influence their gut microbiome, leading to enhanced performance. These findings uncover that diet diversity correlates with gut diversity, which is linked to metabolic benefits and a lean phenotype. Studies on rugby players, cyclists, and marathoners reveal that certain microbial species, like Prevotella and Veillonella, are more abundant in athletes and play significant roles in nutrient metabolism and exercise recovery. These findings suggest that the interaction between athletic lifestyle and the gut microbiota affects positively the metabolism of the host, by enhancing microbiota diversity, and increasing the abundance of beneficial bacteria.
The Short Physical Performance Battery (SPPB) is a well-established tool to assess lower extremity physical performance status. Its predictive ability for all-cause mortality has been sparsely ...reported, but with conflicting results in different subsets of participants. The aim of this study was to perform a meta-analysis investigating the relationship between SPPB score and all-cause mortality.
Articles were searched in MEDLINE, the Cochrane Library, Google Scholar, and BioMed Central between July and September 2015 and updated in January 2016. Inclusion criteria were observational studies; >50 participants; stratification of population according to SPPB value; data on all-cause mortality; English language publications. Twenty-four articles were selected from available evidence. Data of interest (i.e., clinical characteristics, information after stratification of the sample into four SPPB groups 0-3, 4-6, 7-9, 10-12) were retrieved from the articles and/or obtained by the study authors. The odds ratio (OR) and/or hazard ratio (HR) was obtained for all-cause mortality according to SPPB category (with SPPB scores 10-12 considered as reference) with adjustment for age, sex, and body mass index.
Standardized data were obtained for 17 studies (n = 16,534, mean age 76 ± 3 years). As compared to SPPB scores 10-12, values of 0-3 (OR 3.25, 95%CI 2.86-3.79), 4-6 (OR 2.14, 95%CI 1.92-2.39), and 7-9 (OR 1.50, 95%CI 1.32-1.71) were each associated with an increased risk of all-cause mortality. The association between poor performance on SPPB and all-cause mortality remained highly consistent independent of follow-up length, subsets of participants, geographic area, and age of the population. Random effects meta-regression showed that OR for all-cause mortality with SPPB values 7-9 was higher in the younger population, diabetics, and men.
An SPPB score lower than 10 is predictive of all-cause mortality. The systematic implementation of the SPPB in clinical practice settings may provide useful prognostic information about the risk of all-cause mortality. Moreover, the SPPB could be used as a surrogate endpoint of all-cause mortality in trials needing to quantify benefit and health improvements of specific treatments or rehabilitation programs. The study protocol was published on PROSPERO (CRD42015024916).
Few studies have comprehensively analyzed the correlations among body composition parameters, muscle strength, and physical performance, as well as the influence of these factors on the postoperative ...complications and survival after radical gastrectomy for gastric cancer.
A prospective study was conducted including patients who underwent radical gastrectomy for gastric cancer from August 2014 to June 2019. Skeletal muscle index (SMI), skeletal muscle density (SMD), visceral fat area (VFA), subcutaneous fat area (SFA) was obtained by measurement of preoperative computed tomography (CT) images. Grip strength and 6-m gait speed were measured to assess muscle strength and physical performance before surgery.
There was a positive correlation between SMI and SMD, as well as between SFA and VFA. SMD negatively correlated with SFA and VFA. SMI had a positive correlation with VFA, but showed minimal correlation with SFA and visceral to subcutaneous fat ratio (VSR). Grip strength and gait speed were both positively correlated with SMI and SMD, but showed minimal correlation with SFA, VFA and VSR. SMI and grip strength independently predicted postoperative complications, rather than SMD or gait speed. Whereas SMD and gait speed had independent predictive value for overall survival (OS) and/or disease-free survival (DFS), rather than SMI or grip strength. VSR independently predicted postoperative complications, rather than VFA or SFA alone. Low SFA was an independent risk factor for OS and DFS. High VFA was associated with worse survival in overweight patients (body mass index, BMI ≥25), but was associated with better survival in non-overweight patients (BMI <25). High SFA did not significantly influence survival in overweight patients, but was associated with better survival in non-overweight patients.
There is an extensive and complex correlation among body composition parameters, grip strength, and gait speed in patients with operable gastric cancer. A comprehensive analysis of these parameters has significant predictive value for postoperative complications and survival.
The alpha actinin-3 gene (ACTN3) is a significant candidate gene among genetic markers that determine athletic ability. The ACTN3 gene is responsible for the creation of the actin protein in ...fast-twitch muscle fibers, which is associated with muscle power and speed. The objective of this study was to analyze the changes in performance of the arrowhead agility drill test and the distribution of genotype variants in the ACTN3 rs1815739 gene polymorphism in physically active adult males after a 6- week training period. The research will focus on a cohort of 58 male students, aged 19-24, who are enrolled in the Faculty of Sports Sciences and participate in swimming activities. Genomic DNA was extracted from swab samples obtained from participants using the Buccalyse DNA Extraction Kit from Isohelix, following the manufacturer's supplied technique. The study findings revealed that there was no statistically significant difference between all three genotypes when comparing the pre-test and post-test values of the sample group in terms of left and right foot characteristics. Within this framework, it is acknowledged that the outcomes derived from our investigation could potentially influence the research findings. These aspects include the restricted sample size and the incapacity to regulate individual variances such as concentration and motivation during the pre-test and post-test sessions. Nevertheless, it is believed that the results obtained from our study could potentially enhance future research and literary works in the same field.
Abstract Introduction Knowledge about the feasibility and effects of exercise programs to persons with Alzheimer's disease is lacking. This study investigated the effect of aerobic exercise on ...physical performance in community-dwelling persons with mild Alzheimer's disease. Methods The single blinded multi-center RCT (ADEX) included 200 patients, median age 71 yrs (50-89). The intervention group received supervised moderate-to-high intensity aerobic exercise 1 hour × 3/week for 16 weeks. Assessments included cardiorespiratory fitness, single-task physical performance, dual-task performance and exercise self-efficacy. Results Significant between-group differences in change from baseline (mean 95%CI) favored the intervention group for cardiorespiratory fitness (4.0 2.3-5.8 ml/kg/min, P <0.0001) and exercise self-efficacy (1.7 0.5-2.8 points, P =0.004). Furthermore, an exercise attendance of ≥66.6% resulted in significant positive effects on single-task physical performance and dual-task performance. Discussion Aerobic exercise has the potential to improve cardiorespiratory fitness, single-task physical performance, dual-task performance and exercise self-efficacy in community-dwelling patients with mild Alzheimer's disease.
The objective assessment of external physical loads has become promising in better understanding players’ match loads and responses. However, there is a lack of consensus on the metrics used along ...with limited information on this topic in elite handball. This study investigated differences in conventional and novel external load metrics according to playing positions. Methods: 27 matches of EHF Euro M20 2022 were used, with a total of 711 player match observations recorded. The data series were collected using a local positioning system (LPS) integrated with inertial measurement unit (IMU) devices. Kinematic variables: match-jerk, match-Dynamic Stress Load (match-DSL), distance covered, distance covered at high speed (HSR distance). Despite the lack of handball-specific validation, differences between studied positions were found in all variables. Greater sensibility seems possible based on the match-DSL compared to match-jerk. Accordingly, Backs exhibited the highest match-DSL values. Divergently, the Wings covered more distance at total and high-speed running while showing lower match-DSL relative to the Backs. The Line Players had similar HSR distances to Backs while covering lower total distances. Future studies are needed to explore the validity of the available metrics and arbitrary parameters, as well as comparing those variables with internal-load variables.
La evaluación objetiva de las cargas físicas externas se ha convertido en algo promisorio para mejor comprender la carga y la respuesta de un jugador. Sin embargo, hay una falta de consenso sobre las métricas a utilizar junto con información limitada sobre este tema en el balonmano de élite. Este estudio investigó las diferencias con métricas tradicionales y nuevas de carga mecánica externa según las posiciones de juego. Métodos: se utilizaron 27 partidos de la EHF Euro M20 2022, con un total de 711 muestras de jugadores registradas. Data series se recopiló con un sistema de posicionamiento local (LPS) con dispositivos de unidad de medición inercial (IMU) integrados. Variables cinemáticas: match-jerk, match-Dynamic Stress Load (match-DSL), la distancia recorrida y la distancia recorrida a alta velocidad. A pesar de carecer de validación contextual en balonmano, se encontraron diferencias entre las posiciones estudiadas en todas las variables. Parece posible una mayor sensibilidad basada en el match-DSL en comparación con el match-jerk. Los jugadores de primera línea y pivotes exhibieron los valores más altos de match-DSL. De forma divergente, los extremos cubrieron más distancia en carrera a alta velocidad mientras mostraban un menor match-DSL en relación con la primera línea. Las variables de locomoción proporcionan ventajas prácticas en comparación con match-DSL y match-jerk. Futuros estudios son necesarios que exploren la validez de las métricas y parámetros establecidos arbitrariamente y comparen estas variables de carga externa con las de carga interna.
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