八段锦训练防治肌肉衰减征的临床研究

目的 观察八段锦防治肌肉衰减征的临床疗效.方法 募集社区无严重疾病及合并症的老年志愿者22例,女性19例,男性3例,对比观察八段锦训练前和训练1年后的握力、膝关节等速肌力、6 min步行以及下肢肌力和耐力的变化.结果 与训练前比八段锦训练1年后,握力无明显变化.CS-30测试“起-坐”动作频次增加[(23.86 ±4.62)次vs(19.95±4.28)次,P=0.001];左膝关节伸肌群峰力矩[(76.28±21.13)NM vs (48.09±15.79) NM,P＜0.001]、左膝关节屈肌群峰力矩[(37.30± 13.57) NM vs(22.86±11.99) NM,P＜0.001]、右膝关节伸肌群峰力矩[(78.10±21.73)NM vs(45.48±16.91) NM,P＜0.001]、右膝关节屈肌群峰力矩[(37.60±13.86)NM vs(23.29±11.57) NM,P＜0.001]均增强.观察过程中无不良事件发生.结论 八段锦训练能增强下肢肌力并延缓上肢肌力的衰退,可以用于国人肌肉衰减征的预防和治疗.     

抗阻训练对改善帕金森病患者下肢肌力及平衡功能的效果

目的研究抗阻训练对帕金森病(PD)患者下肢肌力及平衡功能的影响。方法将64例PD患者随机分为实验组和对照组各32例。两组患者均接受神经内科常规药物及健康指导,实验组在此基础上进行12 w的抗阻训练。采用下肢等速肌力测试系统、10次坐-立体位试验(STS10)、姿势稳定极限性测试(LOS)和Berg平衡量表(BBS)比较两组训练前后的效果。结果训练前两组患者双下肢髋关节伸肌群、膝关节伸肌群和小腿踝关节背屈肌群的肌力,STS10、LOS和BBS得分均差异无统计学意义(P>0. 05)。12 w抗阻训练后,实验组患者双下肢髋关节伸肌群、膝关节伸肌群和小腿踝关节背屈肌群的肌力,LOS及BBS得分与对照组相比,差异有统计学意义(P<0. 05);实验组训练前后差异有统计学意义(P<0. 05),对照组差异无统计学意义(P>0. 05)。训练后两组患者STS10测试时间比较差异无统计学意义(P>0. 05)。结论抗阻训练可以改善PD患者下肢肌力,对提高患者姿势稳定及平衡能力有积极的效果。     

8w振动训练对老年女性下肢关节肌力和耐力的影响

目的探讨振动训练对老年女性下肢关节肌力和耐力的影响。方法采用美国Power-Plate振动仪对14例60~65岁老年女性,进行8 w,每周3次,20 min/次(频率35~40 Hz,振幅2 mm)的振动训练,并在振动干预前后使用德国Iso Med 2000仪器对受试者的膝、踝关节进行等速肌力测试。结果 1受试者膝和踝关节屈、伸峰力矩增幅分别为15.4%(P=0.040)、16.15%(P=0.030)和22.83%(P=0.002)、16.94%(P=0.042);2膝和踝关节屈、伸肌群肌肉耐力增幅分别为11.90%(P=0.265)、21.43%(P=0.006)和13.79%(P=0.045)、20.75%(P=0.030)。结论8 w的高频振动训练增强了老年女性膝、踝关节屈、伸肌群的力量和耐力,减小了跌倒的风险,说明振动训练对预防老年女性跌倒有积极的效果。     

本体感觉神经肌肉促进技术颈部运动模式对慢性脑卒中患者躯干控制与平衡功能的影响

目的:观察本体感觉神经肌肉促进技术(PNF)颈部运动模式对慢性脑卒中患者躯干控制与平衡功能的作用。方法:选择2014年2月到2016年12月我院收治的101例慢性脑卒中患者。患者被随机分为常规训练组(50例)和PNF组(51例,在常规训练组基础上加用PNF颈部运动模式训练),疗程为4周。测量比较两组训练前后躯干损伤量表(TIS)各维度分及总分、Berg平衡量表(BBS)得分、起立-行走计时测试(TUG)时间。结果:与训练前比较,训练4周后两组TIS各维度分及总分、BBS得分均显著升高,TUG时间显著缩短,P0.05或0.01;与常规训练组比较,PNF组训练4周后静态坐位平衡得分[(5.20±0.83)分比(5.90±0.70)分]、动态坐位平衡得分[(7.35±0.67)分比(7.86±0.72)分]、协调得分[(3.85±0.76)分比(4.67±0.73)分]、TIS总分[(16.80±1.50)分比(18.43±1.60)分]和BBS得分[(37.40±3.45)分比(40.10±3.27)分]升高更显著,TUG时间[(16.84±3.22)s比(15.18±1.83)s]降低更显著,P均0.01。结论:本体感觉神经肌肉促进技术颈部运动模式可以显著提高慢性脑卒中患者的躯干控制与平衡能力,值得推广。     

电针穴位刺激对膝骨性关节炎患者的疗效观察

目的探讨电针穴位刺激对轻中度膝关节骨性关节炎的治疗效果,为今后膝关节骨性关节炎保守治疗提供一定的临床基础。方法选取2019年1月至2020年1月来自国家体育总局运动医学研究所体育医院运动创伤骨科和康复科的轻中度膝关节骨性关节炎患者,随机分为对照组(常规康复训练)和试验组(电针穴位刺激加常规康复训练),2个月后行Lequesne评分和等速肌力测试,比较两组治疗效果。结果治疗2个月后,两组Lequesne评分无统计学差异(P>0.05);等速肌力测试中,两组相对峰力矩(60°/s和240°/s)和耐力比较,电针穴位刺激加常规康复训练组均较单纯行康复治疗组效果好,治疗后60°/s的伸屈肌群PT/TW:试验组屈肌(1.33±0.21),伸肌(2.55±0.41);240°/s伸屈肌群PT/TW:试验组屈肌(0.96±0.11),伸肌(1.41±0.41);伸屈肌群耐力(ER):试验组屈肌(0.77±0.09),伸肌(0.82±0.11),与对照组相比存在统计学差异(P<0.01)。结论电针穴位刺激联合康复训练能够很好地恢复膝关节功能,并能恢复膝关节肌肉力量,是一种针对轻中度骨性关节炎有效的治疗方式。     

城市中老年女性踝关节力量的年龄变化特征

目的 探讨城市中老年女性踝关节力量的衰退特征.方法 实验于2005年3～5月在上海体育学院体质测试中心完成测试.150名受试者按年龄分为3组:40～49岁组、50～59岁组、60～69岁组,每组50名.所有受试者在Contrex肌力测试系统上进行踝关节60°/s的等速肌力测试.观察运动女性踝关节肌力的衰退特征.结果 受试者的踝关节屈肌最大力矩/kg、屈肌最大功率/kg与年龄呈显著负相关(r=-0.449,-0.451,P=0.002);踝关节伸肌最大力矩/屈肌最大力矩与年龄呈正相关(r=0.516,P=0.00).结论 在50～59岁期间,踝关节屈肌力量随年龄增大而迅速衰退,在60～69岁期间衰退趋于平缓;在60～69岁期间,踝关节伸、屈肌衰退明显不平衡,屈肌快于伸肌.     

老年2型糖尿病对骨密度、下肢肌功能、跌倒及骨折的影响

目的研究社区老年2型糖尿病(type 2 diabetes mellitus,T2DM)对骨密度(bone mineral density,BMD)、下肢肌功能、跌倒及骨折的影响。方法选取上海市5家社区卫生服务中心的60岁以上老年人9 584例,其中T2DM组1 201例,对照组8 383例;T2DM患者分为骨折组184例,非骨折组1 017例。分别记录受试者的年龄、性别、身高及体质量,计算出体质量指数(body mass index,BMI),起立行走计时测试(the timed up and go,TUG)评估下肢肌力情况,询问受试者骨折史,吸烟、饮酒情况,1年内跌倒及骨折情况,父母发生髋部骨折史,并询问T2DM患者的病程,药物治疗情况。利用跟骨超声骨密度仪(quantitative ultrasound system-bone mineral density,QUS-BMD)测量骨密度值。比较T2DM与对照组的一般基础资料及发生跌倒和骨折情况,比较T2DM患者骨折组与非骨折组各临床指标。结果 T2DM组吸烟率20.4%明显高于对照组17.8%(P=0.030),完成TUG所需中位数时间10.75 s明显高于对照组10.12 s(P=0.000),BMD(0.920±0.040)g/cm~2高于对照组(0.790±0.030)g/cm~2(P=0.000),1年内跌倒发生率10.1%高于对照组7.1%(P=0.000),1年内骨折发生率15.3%高于对照组12.1%(P=0.080);T2DM患者中,与非骨折组相比,骨折组女性的比例高(89.1%vs.52.1%,P=0.000)、糖尿病病程长[(11.6±0.6)年vs.(9.6±0.2)年,P=0.000]、吸烟比率高(95.1%vs.67.9%,P=0.000)、饮酒比率高(93.5%vs.80.7%,P=0.000)、使用胰岛素比率高(23.9%vs.14.9%,P=0.002)、父母髋部骨折史高(9.2%vs.3.7%,P=0.001)、1年内发生跌倒率高(20.7%vs.8.3%,P=0.000)、跌倒风险评分高[(2.98±0.01)分vs.(1.8±0.01)分,P=0.000]、TUG高(10.92 s vs.10.34 s,P=0.000)、骨密度低[(0.635±0.026)g/cm~2vs.(0.780±0.030)g/cm~2,P=0.000]。结论与对照组相比,患T2DM的老年人虽然BMD高,但是下肢肌功能降低、跌倒及骨折的发生率明显增高,揭示T2DM降低了老年人肌肉功能,增加了跌倒和骨折的发生,且该作用独立于BMD以外。     

全身振动训练对老年人肌肉-骨骼-关节的影响

目的探讨全身振动训练对老年人骨密度(BMD)、下肢肌力和膝关节活动度的影响。方法将入选的76例老年人按性别分组,组内随机分为训练组和对照组。观察振动训练前后腰椎L2~L4和股骨颈的BMD、下肢肌力、膝关节活动度变化。结果 (1)训练组腰椎L2~L4和股骨颈BMD均有不同程度提高,对股骨颈BMD效果略好于腰椎L2~L4,其中女性股骨颈BMD提升最为显著,对老年女性BMD的效果明显优于老年男性(均P<0.05)。(2)训练组下肢肌力、膝关节活动度和抗骨折能力均明显提升,下肢肌力提升最为明显(均P<0.05)。结论全身振动训练能提高老年人腰椎及股骨颈BMD,有效提升下肢肌力和改善膝关节活动度。     

等速肌力训练对脑卒中后上肢功能障碍患者上肢运动功能的影响

目的:研究等速肌力训练对脑卒中患者上肢运动功能的影响。方法:2016年1月-2017年10月于我院治疗的90例脑卒中后上肢功能障碍患者被随机均分为常规康复组和联合训练组(在常规康复组基础上接受等速肌力训练),两组均治疗4周。观察比较两组治疗前后Fugl-Meyer运动功能量表(FMA)评分、改良Ashworth量表(MAS)评分、改良Barthel指数(MBI)评分及以角速度60°/s、120°/s伸屈时肘伸肌、肘屈肌峰力矩(PT)、总功(TW)、平均功率(AP)。结果:与治疗前比较,治疗后两组FMA评分、MBI评分、以角速度60°/s、120°/s伸屈时肘伸肌及肘屈肌PT、TW、AP均显著升高(P均=0.001),治疗后两组MAS评分无显著差异(P均>0.05)。与常规康复组比较,联合训练组治疗后FMA评分[(49.28±6.73)分比(56.79±6.24)分]、MBI评分[(59.92±9.33)分比(70.14±9.39)分]、以角速度60°/s、120°/s伸屈时肘伸肌:PT[60°/s(17.25±3.66)N·m比(21.48±4.21)N·m,120°/s(10.74±3.80)N·m比(15.69±4.21)N·m]、TW[60°/s(165.74±20.51)J比(194.67±23.55)J,120°/s(209.67±25.28)J比(258.76±26.72)J]、AP[60°/s(11.28±3.35)W比(15.42±4.14)W,120°/s(11.58±3.65)W比(17.83±3.74)W]升高更显著(P均=0.001),以角速度60°/s、120°/s伸屈时肘屈肌:PT、TW、AP均无显著差异(P均>0.05)。结论:等速肌力训练可显著促进脑卒中后上肢功能障碍患者上肢运动功能的恢复,提高日常生活活动能力。     

Biodex等速系统测试老年人膝关节屈伸肌力可靠性的初步研究

目的确定Biodex等速系统测试老年人膝关节伸肌和屈肌等速向心肌肉功能的可靠性。方法使用Biodex System 3型多关节等速系统在2个测试日对20名老年人（年龄71±6岁）的双下肢进行等速向心肌力测试。结果除了屈肌的作功疲劳度值,伸肌和屈肌两次测试的峰力矩、单次最大作功和平均功率值差异均有统计学意义（P〉0．05）。伸肌和屈肌两次重复测试的相关系数在0．40～0．96之间,除屈肌的作功疲劳度值的P值〉O．05,其余各指标的P值均〈0．05,具有相关关系。结论采用Biodex等速系统对老年人膝关节伸肌和屈肌进行的肌肉功能的重复测试之间具有较好的可靠性。同时提示,有必要加强测试程序的标准化、测试前的热身和熟练程序。     

机器人系统辅助的膝关节单髁置换术治疗老年膝关节骨关节炎的临床效果

目的 探讨机器人手术系统辅助下膝关节单髁置换术(UKA)和传统膝关节单髁置换术治疗老年患者膝关节骨关节炎的疗效。方法 选择2018年1月至2020年6月就诊于解放军总医院第一医学中心78例老年膝关节骨关节炎患者为研究对象,按照随机数表法随机分为2组,每组39例。观察组实施MAKO RIO机器人手术系统辅助下UKA,对照组实施常规膝关节单髁置换术。对比2组患者围术期情况,术后8、16、24h 2组患者视觉模拟评分法(VAS)及术后6个月美国膝关节协会评分(KSS)。结果 观察组单侧 UKA手术时间(155±22) min、术中止血带使用时间 (27±10) min、术后第2天总失血量 (476±290) ml;对照组分别为 (135±21) min、(40±9) min、(536±215) ml,差异均有统计学意义(均P<0.05)。观察组术后8、16h VAS评分分别为(3.2±1.2)、(1.8±0.8) 分,对照组分别为(4.6±1.4)、(2.3±1.1)分,差异均有统计学意义(均P<0.05)。观察组和对照组术后24h VAS评分分别为(1.1±0.3)、(1.2±0.5)分,差异无统计学意义(P>0.05)。对照组术后6个月随访患侧膝关节KSS临床评分和功能评分分别为(78±11)、(70±16)分,观察组分别为(90±6)、(79±12)分,差异均有统计学意义(均P<0.05)。结论 机器人手术系统辅助UKA能够实现微创条件下精准手术,具有良好的安全性,促进了手术患者膝关节功能改善。     

Impact of different bilateral knee extension strengths on lower extremity performance

Despite the impact of leg muscle strength on lower extremity motor performance—including walking and sit-to-stand transfer—it remains difficult to predict the relationship between bilateral leg muscle strength and lower extremity performance. Therefore, this study was designed to predict lower extremity function through the differential modeling of logarithmic and linear regression, based on knee extension strength.The study included 121 individuals living in the same community. The bilateral strengths of the knee extensors were measured using a handheld dynamometer, and the Timed Up & Go test (TUG) performance time and 5-m minimum walking times were assessed to predict lower extremity motor functions. Bilateral normalized knee extension muscle strengths and lower extremity motor function scores, including walking or TUG performance times, were assessed on the logarithmic and linear models. The Akaike information criterion (AIC) was used to evaluate the coefficient compatibility between the logarithmic regression model and the linear regression model.The AIC value for the linear model was lower than that for the logarithmic model regarding the walking time. For walking time estimation in the linear model, the coefficient value of knee extension strength was larger on the strong than on the weak side; however, the AIC value for the logarithmic model was lower than that for the linear model regarding TUG performance time. In the logarithmic model''s TUG performance time estimation, the coefficient value of knee extension strength was larger on the weak than on the strong side.In conclusion, our study demonstrated different models reflecting the relationship between both legs’ strengths and lower extremity performance, including the walking and TUG performance times.     

Daily Passive Muscle Stretching Improves Flow-Mediated Dilation of Popliteal Artery and 6-minute Walk Test in Elderly Patients with Stable Symptomatic Peripheral Artery Disease

BackgroundPatients with peripheral arterial disease (PAD) often have walking impairment due to insufficient oxygen supply to skeletal muscle. In aged rats, we have shown that daily stretching of calf muscles improves endothelium-dependent dilation of arterioles from the soleus muscle and increases capillarity and muscle blood flow during exercise. Therefore, we hypothesized that daily muscle stretching of calf muscles would improve endothelium-dependent vasodilation of the popliteal artery and walking function in PAD patients.MethodsWe performed a randomized, non-blinded, crossover study whereby 13 patients with stable symptomatic PAD were randomized to undergo either 4 weeks of passive calf muscle stretching (ankle dorsiflexion applied 30 min/d, 5 days/wk) followed by 4 weeks of no muscle stretching and vice versa. Endothelium-dependent flow-mediated dilation (FMD) and endothelium-independent nitroglycerin-induced dilation of the popliteal artery and 6 minute walk test (6MWT) were evaluated at baseline and after each 4 week interval.ResultsAfter 4 weeks of muscle stretching, FMD and 6MWT improved significantly in the muscle stretching group vs. the control (FMD: 5.1 ± 0.5% vs. 3.7 ± 0.3%, P = 0.005; 6MWT continuous walking distance: 304 ± 43 m vs. 182 ± 34 m; P = 0.0006). No difference in nitroglycerin-induced dilation was found between groups (10.9 ± 1.2 vs. 9.9 ± 0.4%, P = 0.48). Post-stretching, 6MWT total walking distance was positively correlated with normalized FMD (R = 0.645, P = 0.02).ConclusionsPassive calf muscle stretching enhanced vascular endothelial function and improved walking function in elderly patients with stable symptomatic PAD. These findings merit further investigation in a prospective randomized trial.     

本体感觉训练对步行能力下降老年患者康复的效果

目的 探讨本体感觉训练对步行能力下降老年患者康复的效果.方法 选取2017年3月至2019年7月在空军军医大学西京医院老年病科住院的68例步行能力下降的老年患者,采用随机数表法分为试验组和对照组,每组34例.对照组采用常规步行能力训练,试验组在常规治疗基础上增加本体感觉训练.比较2组患者治疗前及治疗8周后Holden功...     

集落刺激因子-1自背根节向脊髓转运在长春新碱诱导神经病理性疼痛中的作用

目的探讨集落刺激因子-1(CSF-1)自背根节向脊髓转运在长春新碱诱导神经病理性疼痛中的作用及其机制。方法健康雄性SD大鼠30只,采用随机数表法分为3组:正常对照组、化疗所致神经病理性疼痛(CINP)组(隔日腹腔注射长春新碱建立CINP模型)和背根切断(DRR)组(切断腰4～6背根后,建立CINP模型),每组10只。采用机械缩足反射阈值(MWT)和热缩足反射潜伏期(TWL)评价大鼠机械痛敏和热痛敏。Western blotting检测背根节和脊髓CSF-1、以及离子钙结合适配器分子1(Iba1)表达;免疫荧光化学法检测脊髓Iba1表达;逆转录-聚合酶链反应法检测背根节和脊髓CSF-1 mRNA表达。采用SPSS 19.0软件进行数据处理。组间比较采用单因素方差分析。结果与对照组比较,腹腔注射长春新碱3、5、7 d后,CINP组和DRR组大鼠的MWT和TWL均显著降低(P0.01);与CINP组比较,DRR组大鼠在给药3、5、7 d后的MWT和TWL均显著升高(P0.01)。与对照组相比,CINP组大鼠背根节[(0.21±0.04)和(1.08±0.15)]和脊髓CSF-1蛋白表达[(0.22±0.05)和(1.17±0.14)]、脊髓Iba1蛋白表达[(100±0)%和(250±19)%]、背根节CSF-1 mRNA表达[(0.20±0.05)和(1.02±0.10)]均显著升高(P0.05);与CINP组相比,DRR组大鼠脊髓CSF-1蛋白表达[(1.17±0.14)和(0.45±0.06)]、脊髓Iba1蛋白表达[(250±19)%和(130±16)%]均显著降低(P0.05)。结论长春新碱诱导CINP的机制可能与CSF-1自背根节向脊髓转运激活小胶质细胞有关。     

Walking with Non-Invasive Ventilation Does Not Prevent Exercise-Induced Hypoxaemia in Stable Hypercapnic COPD Patients

Background: Non-invasive positive pressure ventilation (NPPV) in addition to supplemental oxygen improves arterial oxygenation, walking distance and dyspnea when applied during exercise in stable hypercapnic COPD patients. The aim of the current study was to investigate whether NPPV without supplemental oxygen is capable of preventing severe exercise-induced hypoxemia in these patients when applied during walking. Methods and Results: 15 stable hypercapnic COPD patients (FEV1 29.9 ± 15.9%) performed two 6-minute walk tests (6MWT) with a rollator in a randomized cross-over design: using either supplemental oxygen

(2.4 ± 0.7 L/min) or NPPV (inspiratory/expiratory positive airway pressure of 28.2 ± 2.8 / 5.5 ± 1.5 mbar) without supplemental oxygen. Results: 10 patients were able to complete both 6MWT. 6MWT with supplemental oxygen resulted in no changes for PO2 (pre: 67.3 ± 11.2 mmHg vs. post: 65.6 ± 12.0 mmHg, p = 0.72) whereas PCO2 increased (pre: 50.9 ± 8.1 mmHg vs. post: 54.3 ± 10.0 mmHg (p < 0.03). During 6MWT with NPPV PO2 significantly decreased from 66.8 ± 7.2 mmHg to 55.5 ± 10.6 mmHg (p < 0.02) whereas no changes occurred in PCO2 (pre: 50.6 ± 7.5 mmHg vs. post: 53.0 ± 7.1 mmHg; p = 0.17). Walking distance tended to be lower in 6MWT with NPPV compared to 6MWT with supplemental oxygen alone (318 ± 160 m vs. 377 ± 108 m; p = 0.08). Conclusion: The use of NPPV during walking without the application of supplemental oxygen does not prevent exercise-induced hypoxemia in patients with stable hypercapnic COPD.     

去肾交感神经术对窄QRS波慢性重度心力衰竭患者心功能及ICD放电的作用

目的:探讨射频消融去肾交感神经术(RDN)对窄QRS波慢性重度心力衰竭并置入埋藏式心脏复律除颤器(ICD)患者心功能和恶性心律失常的改善作用。方法:入选7例心电图QRS波群0.12s、左室射血分数(LVEF)35%的慢性重度心力衰竭患者,各例于置入ICD后进行RDN治疗,记录患者RDN术前及术后6个月的血生化指标、超声心动图指标、6 min步行距离和ICD放电次数。结果:与RDN术前相比,7例患者RDN术后6个月时收缩压[(116.71±11.34)mmHg对(132.57±10.98)mmHg,P=0.021]、血清脑钠肽(BNP)水平[(384.19±178.00)pg/mL对(1243.25±712.75)pg/mL,P=0.009)显著降低,6min步行距离显著增加[(434.57±27.17)m对(128.14±19.88)m,P0.001);左室收缩末期内径[(45.00±8.27)mm对(53.86±7.54)mm,P=0.014]和左房内径[(39.60±7.55)mm对(43.43±10.44)mm,P=0.042]显著降低,LVEF显著升高[(38.29±8.67)%对(29.29±2.14)%,P=0.021];与术前相比,RDN后6个月内患者因恶性心律失常引起的ICD放电次数有所减少。结论:RDN能有效改善窄QRS波慢性重度心力衰竭患者心功能,提高运动耐量,减少ICD放电。     

Knee joint stiffness during walking in knee osteoarthritis

Objective

To investigate the construct validity of walking knee stiffness as a measure to differentiate between individuals with and without knee osteoarthritis (OA) and the construct validity of walking knee stiffness as related to self‐reported knee stiffness. The contributors to walking stiffness and its relationship with loading rate and adduction moment are also investigated.

Methods

Thirty‐seven individuals with knee OA and 11 asymptomatic controls participated. Knee stiffness was calculated during walking as the change in knee flexion‐extension moment divided by the change in knee flexion angle. Forward‐stepwise regression models and Pearson's correlation coefficients were used to evaluate the relationships between variables.

Results

Knee stiffness in walking was significantly greater in the OA group (mean ± SD 10.1 ± 4.4 Nm/°/kg × 100) compared with the controls (mean ± SD 5.6 ± 1.5 Nm/°/kg × 100) (P < 0.001). Knee excursion range explained 39% of the variance in walking knee stiffness (B = ?0.736, P < 0.001) and knee extensor moment a further 7% (B = 6.974, P = 0.045). In the OA group, walking knee stiffness was not associated with self‐reported stiffness (r = 0.029; P = 0.863). For the OA group, greater self‐reported stiffness was associated with lower peak knee adduction moment (B = ?0.354, P < 0.001).

Conclusion

The construct validity of walking knee stiffness is supported. The poor correlation between walking stiffness and self‐reported stiffness suggests the 2 measures evaluate different aspects of knee stiffness. Since a measure of walking stiffness is likely to provide valuable information, future research evaluating its clinical significance is merited.

     

Predictors of functional recovery (FR) for elderly hospitalized patients in a geriatric evaluation and management unit (GEMU) in Taiwan

Elderly patients who are hospitalized with acute illnesses frequently have adverse outcomes. To maintain functional independence, the geriatric evaluation and management unit (GEMU) was established to provide the opportunity for functional recovery (FR). This study's aim was to investigate potential prognostic factors for functional improvement in a GEMU of Taichung Veterans General Hospital, Taiwan. A total of 117 elderly patients (age, 80.0±6.3 years, 84.6% males) were enrolled. A comprehensive geriatric assessment and functional status evaluation, including the functional reach test (FRT) and the timed up-and-go (TUG) test, were performed. FR was defined by a greater than 10% improvement in the Barthel Index (BI) before GEMU discharge. Lower BI (44.7±25.2 vs. 68.7±34.5, p < 0.001), lower instrumental activities of daily living (IADL) scores (1.8±1.5 vs. 3.5±2.6, p < 0.001), impaired FRT (83.3% vs. 63.5%, p = 0.028), and impaired TUG test (94.4% vs. 74.6%, p = 0.008) were predictive factors for functional improvement. On multivariate logistic regression, an impaired TUG test (Odds ratio = OR = 6.18, 95% confidence interval = 95% C.I. = 1.69–22.6, p = 0.006) was an independent variable associated with FR. The results indicate that elderly hospitalized patients, even with poor physical function, could benefit from geriatric integrated care delivered by a GEMU.