Muscle disorders in cirrhosis are associated with poor outcome and need early identification. Anthropometric measures lack sensitivity, and CT-based L3-skeletal muscle Index (L3-SMI) may miss early ...sarcopenia. The study aimed to find if SM-RA can identify more patients with muscle disorder than L3-SMI and anthropometry.
388 patients with cirrhosis underwent nutritional assessment by anthropometry, short-physical-performance-battery (SPPB) < 9, L3-SMI (<36.5 cm2/m2 (males); <30.2 cm2/m2 (females), and myosteatosis assessment by skeletal muscle radiation attenuation (SM-RA) (<41 HU for body mass index BMI <24.9 kg/m2 and <33 HU for ≥25 kg/m2) and results were compared.
Sarcopenia based on SPPB was 38.9 % with scores (9 ± 1.48 vs. 10.74 ± 1.25, P = 0.001 in males; and 8.43 ± 1.59 vs. 9.89 ± 1.57, P = 0.001 in females). Mid-arm muscle circumference was lower in sarcopenic males 20.5 ± 2.42 vs. 22.9 ± 2.19 cm, P = 0.001 but not in females 19.4 ± 2.73 vs. 21.1 ± 2.51, P = 0.18. L3-SMI-based sarcopenia was found in 44.8 % (additional 5.92 %) compared to SPPB, mostly in cryptogenic cirrhosis (19.2 % vs. 35.08 %, δ change +15.9 %). Myosteatosis (71.64 %) identified an additional 26.85 % and 32.74 % of patients with muscle disorder compared to L3SMI and SPPB, respectively, with the majority of new detection in non-alcoholic fatty liver disease (NAFLD) 39.4 % vs. 77.06 %, δ change +37.66 %) CTP-A patients (16.6 % vs. 36.8 %, δ change +20.2 %). Myosteatosis was found in 48.3 % of patients with normal L3-SMI.
SM-RA can identify more patients with muscle disorder than L3-SMI and SPPB.
Background
After acute lymphoblastic leukemia (ALL) treatment, children can have persistent muscle weakness, range of motion limitations, and decreased function after treatment. The Stoplight Program ...(SLP), a proactive physical therapy intervention, was administered as the standard of care during ALL treatment to prevent and minimize these impairments. The purpose of this follow‐up study was to measure body function and activity limitations in ALL survivors who completed the SLP and compare them to a pre‐SLP control group, thus evaluating the longer term impact of the SLP.
Procedure
Two cohorts of survivors of pediatric ALL ages 5 to 18 years were assessed 18 to 24 months after completing ALL treatment. Measurements included both the body coordination subtest and the strength and agility subtest of the Bruininks‐Oseretsky Test of Motor Proficiency, active dorsiflexion range of motion (ADROM), and physical activity by self‐report.
Results
The control group and SLP group did not differ in size (n = 15), mean age (9 years), or time off ALL treatment (20 months). The SLP group had better scale scores for bilateral coordination (P = 0.05), running speed/agility (P < 0.01), and strength (P = 0.01). The number of survivors with 5 degrees or greater of ADROM (right) was significantly greater in the SLP group. ADROM had a positive correlation with strength/agility standard score in the combined survivor group.
Conclusion
The SLP is a proactive physical therapy intervention that continues to positively impact children after treatment. Referral to physical therapy should be the standard to optimize long‐term function.
Abstract Osteoporosis, vertebral fractures, and spinal degenerative diseases are common conditions that often coexist in older adults. This study aimed to determine the factors influencing low back ...pain and its impact on activities of daily living (ADL) and physical performance in older individuals with multiple comorbidities. This cross-sectional study was part of a large-scale population-based cohort study in Japan, involving 1009 participants who underwent spinal magnetic resonance imaging (MRI) to assess cervical cord compression, radiographic lumbar spinal stenosis, and lumbar disc degeneration. Vertebral fractures in the thoracolumbar spine were evaluated using sagittal MRI with a semi-quantitative method. Bone mineral density was measured using dual-energy X-ray absorptiometry. Low back pain, Oswestry Disability Index (ODI), and physical performance tests, such as one-leg standing time, five times chair-stand time, maximum walking speed, and maximum step length, were assessed. Using clinical conditions as objective variables and image evaluation parameters as explanatory variables, multiple regression analysis showed that vertebral fractures were significantly associated with low back pain and ODI. Vertebral fractures and osteoporosis significantly impacted physical performance, whereas osteoporosis alone did not affect low back pain or ODI. Our findings contribute to new insights into low back pain and its impact on ADL and physical performance.
•The relationship between physical performance and hip fracture is point out.•Participants with hip fractures had poorer physical performance than those without hip fractures.•After adjustment for ...potential confounding factors, a significant risk gradient for hip fracture was associated with the SPPB score and repeated chair stands.•No modification effect of cognition function was found on the relationship between physical performance and hip fracture.
This study aims to evaluate the association between the risk of hip fracture and score on the Short Physical Performance Battery (SPPB) and handgrip strength in community-dwelling elderly people in China.
A total of 5,958 community-dwelling Chinese people aged 60 years or more from the China Health and Retirement Longitudinal Study (CHARLS) were surveyed in 2011 (baseline) and followed through to 2016. Score on the SPPB (which comprises tests of balance, walking speed, and repeated chair stands) and handgrip strength were determined at baseline. Binary logistic regression models were used to estimate the risk ratio (RR) and 95 % CI.
During an average of approximately 4 years of follow-up, 180 (3.0 %) participants experienced incident hip fracture. After multivariate adjustment, the overall SPPB score and repeated chair stands alone distinguished a gradient of hip fracture risks. The risk of hip fracture was 1.65-fold higher in poor SPPB performers (score 0−6) than in good SPPB performers (score 10−12). Participants unable to complete repeated chair stands, and those who took ≥16.7 s or 13.7–16.6 s to complete them, had a higher risk than those who took ≤ 11.1 s to complete them, with RRs of 2.45, 2.12, and 1.93, respectively. Participants unable to complete the balance tests had a higher hip fracture risk than those with scores of 4, with an RR of 2.16. Walking speed and handgrip strength were not associated with increased hip fracture risk.
Among community-dwelling elderly Chinese people, overall SPPB score, as well as performance on repeated chair stands and balance tests within the SPPB, were significantly and independently associated with increased hip fracture risk. These indicators could be used to predict hip fracture in clinical settings.
Successful sports performance is characterized by psychological, physical, technical, and tactical factors. Of these factors, the psychological factor is typically ignored despite contributing more ...than 50% toward success in sporting performance. This review aimed to introduce the Kawa model as a new methodology to promote sports and physical performance through developing mental health ability. The Kawa model is developed by occupational therapists and used to promote mental health ability in individuals by enabling self-awareness of their difficulties and exploring possible solutions. It consists of the following five elements: water, river banks, rocks, driftwood, and space. This research would further explore the usage of the Kawa model in addressing various psychological issues and how these improvements can enhance sports and physical performance. The literature search was performed by using Google Scholar, PubMed, Web of Science and Scopus as a database with specific keywords. In conclusion, this research provides an overview of the potential for the use of the Kawa model in promoting mental health ability included self-awareness, self-understanding, goal-setting, self-efficacy, stress and anxiety control for sports and physical performance and lays the foundation for future research in this area.
Force production is crucial in football, and it is the main limitation of people with cerebral palsy (CP). This study aimed to describe the changes in sprint force-velocity (Fv) profile after a ...period of 25 weeks of regular training in international football players with CP.
The sprint Fv profile and other physical performance variables (ie, linear sprint, vertical jump, change of direction, and intermittent endurance) of 14 international players from the Spanish national team were assessed during 2 consecutive training camps. Pretesting and posttesting sessions were carried out 1 week before and after the 25-week intervention period. The intervention consisted of 2 strength sessions per week added to the usual football training.
The repeated-measures analysis of variance showed changes in players' physical performance (linear sprint: F = 18.05, P < .01; change of direction: F = 16.71, P < .01; and endurance: F = 31.45, P < .01) and in some variables of the sprint Fv profile (maximal horizontal force, maximal power, slope, maximal ratio of force, and decrease of ratio of force; F = 14.28-37.81; P < .01), whereas players' maximal velocity (theoretical and actual) did not change (F = 0.13 and 0.01; P = .72 and .98, respectively).
This study showed that the implementation of 2 strength-training sessions per week, for 25 weeks, is effective to improve CP football players' physical performance. The main finding of this study is the improvement of force application in the acceleration phase (sprint Fv profile), which is the main attribute in many physical performance tests and is the main limitation of the CP population.
Sarcopenia has been recognized as a muscle disease, with adverse consequences on health. Updated recommendations, aimed at increasing awareness of sarcopenia and its accompanying risks, have been ...produced to urge the early detection and treatment of this disease. Recommended treatment is based on an individually tailored resistance exercise training program, the optimization of protein intake using high-quality protein sources (i.e., whey protein) in order to provide a high amount of essential amino acids-particularly leucine-and addressing vitamin D deficiency/insufficiency. The purpose of this review is to collate and describe all of the relevant efficacy studies carried out with a muscle-targeted oral nutritional supplementation (MT-ONS)-namely a whey-protein-based, leucine- and vitamin D-enriched formula aimed at optimizing their intake and satisfying their requirements-in different patient populations and clinical settings in order to determine if there is enough evidence to recommend prescription for the treatment of sarcopenia or its prevention in high-risk patient populations. Trials using a MT-ONS with or without a concomitant physical exercise program were systematically searched (up to June 2021), and those addressing relevant endpoints (muscle mass, physical performance and function) were critically reviewed. In total, 10 articles providing efficacy data from eight trials were identified and narratively reviewed. As far as older patients with sarcopenia are concerned, MT-ONS has been pertinently tested in six clinical trials (duration 4-52 weeks), mostly using a high-quality randomized controlled trial design and demonstrating efficacy in increasing the muscle mass and strength, as well as the physical performance versus iso-caloric placebo or standard practice. Consistent results have been observed in various clinical settings (community, rehabilitation centers, care homes), with or without adjunctive physical exercise programs. A positive effect on markers of inflammation has also been shown. A muscle-protein-sparing effect, with benefits on physical performance and function, has also been demonstrated in patients at risk of losing skeletal muscle mass (three trials), such as older patients undergoing weight loss or intensive rehabilitation programs associated with neurological disability (Parkinson's disease). MT-ONS has demonstrated not only a significant efficacy in clinical variables, but also a positive impact on healthcare resource consumption in the rehabilitation setting (length of stay and duration of rehabilitation). In summary, MT-ONS, alone or in association with an appropriate exercise program, is an effective therapy for older patients with sarcopenia and should be offered as a first-line treatment, not only to improve clinical outcomes but also to reduce healthcare resource consumption, particularly in patients admitted to a rehabilitation center.
Purpose
Spaceflight impairs physical capacity. Here we assessed the protective effect of artificial gravity (AG) on aerobic exercise capacity and muscle function during bed rest, a spaceflight ...analogue.
Methods
24 participants (33 ± 9 years, 175 ± 9 cm, 74 ± 10 kg, 8 women) were randomly allocated to one of three groups: continuous AG (cAG), intermittent AG (iAG) or control (CTRL). All participants were subjected to 60 days of six-degree head-down tilt bed rest, and subjects of the intervention groups completed 30 min of centrifugation per day: cAG continuously and iAG for 6 × 5 min, with an acceleration of 1
g
at the center of mass. Physical capacity was assessed before and after bed rest via maximal voluntary contractions, cycling spiroergometry, and countermovement jumps.
Results
AG had no significant effect on aerobic exercise capacity, flexor muscle function and isometric knee extension strength or rate of force development (RFD). However, AG mitigated the effects of bed rest on jumping power (group * time interaction of the rmANOVA
p
< 0.001; iAG − 25%, cAG − 26%, CTRL − 33%), plantar flexion strength (group * time
p
= 0.003; iAG − 35%, cAG − 31%, CTRL − 48%) and plantar flexion RFD (group * time
p
= 0.020; iAG − 28%, cAG − 12%, CTRL − 40%). Women showed more pronounced losses than men in jumping power (
p
< 0.001) and knee extension strength (
p
= 0.010).
Conclusion
The AG protocols were not suitable to maintain aerobic exercise capacity, probably due to the very low cardiorespiratory demand of this intervention. However, they mitigated some losses in muscle function, potentially due to the low-intensity muscle contractions during centrifugation used to avoid presyncope.
Restless legs syndrome (RLS) is a sleep disorder that occurs in approximately 26 % of adults with multiple sclerosis (MS) and may be associated with reduced physical function.
The present study ...examined the relationship between RLS symptomology (i.e., overall severity, frequency, and occurrence) and physical function outcomes in adults with MS who had RLS.
Participants (N = 22) with MS who had RLS came into the laboratory for a single session wherein a rater performed a brief neurological examination for scoring the Expanded Disability Status Scale (EDSS) and completed a demographics questionnaire, the International Restless Legs Syndrome Study Group Scale (IRLS), and the Restless Legs Syndrome Scale-6 (RLS-6) followed by the Short Physical Performance Battery (SPPB) and the Six-minute Walk Test (6 MW).
Bivariate Spearman’s rho correlation analyses indicated total IRLS had a strong, negative association with total distance traveled during the 6 MW (ρ = −0.50) and a moderate association with SPPB scores (ρ = −0.43), but not EDSS scores (ρ = 0.28). RLS severity during the day while active had strong, negative associations with total distance traveled during the 6 MW (ρ = −0.61) and SPPB scores (ρ = −0.52), but not EDSS scores (ρ = 0.13).
We observed associations between worse overall RLS severity and RLS severity during the day while active with reduced performance during the 6 MW and lower SPPB scores. The management of RLS may offer an opportunity for mitigating reductions in physical function in adults with MS who have RLS.
•RLS symptoms were highest at falling asleep followed by during the day while resting.•Overall RLS severity was associated with worse walking endurance and physical function in people with MS.•RLS severity during the day while active was associated with worse walking endurance and physical function in people with MS.
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