Effects of line dancing on physical function and perceived limitation in older adults with self-reported mobility limitations

Introduction: Older adults with mobility limitations are at greater risk for aging-related declines in physical function. Line dancing is a popular form of exercise that can be modified, and is thus feasible for older adults with mobility limitations.

Purpose: The purpose of this study was to assess the effects of 8 weeks of line dancing on balance, muscle strength, lower extremity function, endurance, gait speed, and perceived mobility limitations.

Methods: An experimental design randomly assigned older adults to either an 8-week line dancing or usual care group. The convenience sample consisted of 23 participants with mobility limitations (age range: 65–93?years). The intervention used simple routines from novice line dance classes. At baseline and at 8 weeks, balance, knee muscle strength, lower extremity function, endurance, gait speed, and mobility limitations were measured. ANCOVA tests were conducted on each dependent variable to assess the effects of the intervention over time.

Results: Results found significant positive differences for the intervention group in lower extremity function (p?p?p?p?Conclusions: Eight weeks of line dancing significantly improved physical function and reduced self-reported mobility limitations in these individuals. Line dancing could be recommended by clinicians as a potential adjunct therapy that addresses mobility limitations.

• Implications for Rehabilitation

• Line dancing may be an alternative exercise for older adults who need modifications due to mobility limitations.

• Line dancing incorporates cognitive and motor control.

• Line dancing can be performed alone or in a group setting.

• Dancing improves balance which can reduce risk of falls.

     

Clinical relevance of the modified physical performance test versus the short physical performance battery for detecting mobility impairments in older men with peripheral arterial disease

Abstract

Purpose: The study is to compare the Modified Physical Performance Test (MPPT) and Short Physical Performance Battery (SPPB) as metrics of mobility and function in older men with peripheral arterial disease (PAD).

Materials and methods: A total of 51 men (55–87?years) with PAD underwent functional testing including the SPPB, MPPT, Walking Impairment Questionnaire (WIQ), stair ascent, and 6-min walk distance. Individuals were grouped according to SPPB and MPPT scores as not limited on either, limited only on the MPPT, or limited on both.

Results: The MPPT identified a higher proportion of patients as being functionally limited than the SPPB (p?<?0.001). Men identified as limited only by the MPPT, and not the SPPB, were subsequently confirmed to have lower function on all measures compared to those not identified as limited by either the SPPB or the MPPT (p?<?0.02).

Conclusions: These findings suggest the MPPT is an appropriate measure to identify early declines in men with PAD and may identify global disability better than SPPB.

• Implications for rehabilitation

• Individuals with peripheral arterial disease have low activity levels and are at risk for a loss of independence and global disability.

• Early detection of decline in mobility and global function would allow for interventions before large changes in ambulatory ability or a loss of functional independence occur.

• This study shows the Modified Physical Performance Test may be an appropriate test to identify early decline in function in men with peripheral arterial disease.

     

Improving maintenance of physical activity in older, knee osteoarthritis patients trial-pilot (IMPACT-P): design and methods

Promoting increased physical activity participation is now consistently advocated in the medical management of knee osteoarthritis (OA). Unfortunately, physical activity interventions targeting older knee OA patients are plagued by high attrition rates and poor long-term adherence. Consequently, identifying effective approaches for promoting maintenance of physical activity participation is integral for the successful behavioral management of knee OA. The present study, the Improving Maintenance of Physical Activity in Knee Osteoarthritis Pilot Trial (IMPACT-P), was a single-blind two-arm, randomized controlled pilot study designed to contrast the effects of a group-mediated cognitive behavioral (GMCB) exercise intervention with those of traditional center-based exercise therapy approach (TRAD) in older, knee OA patients. A total of 80 older adults with symptomatic knee OA were randomly assigned to GMCB or TRAD interventions. The primary outcome of the IMPACT-P study was changed in self-reported (CHAMPS questionnaire) and objectively assessed (LIFECORDER EX Plus) physical activity participation of moderate intensity or greater. Secondary outcomes include physical function, quality of life, and social cognitive variables. Outcomes were obtained at baseline, 3 month, and 12 month assessments by trial personnel blinded to participants' randomization assignment. Discussion. Determining the comparable efficacy of the GMCB and TRAD exercise interventions in producing meaningful improvements in physical activity and OA outcomes could enhance the efficacy of implementing physical activity participation in the behavioral management of symptomatic knee OA.     

The Mental Activity and eXercise (MAX) trial: Effects on physical function and quality of life among older adults with cognitive complaints

BackgroundOlder adults with cognitive complaints are vulnerable to dementia, physical impairments, and poor quality of life. Exercise and mental activity may improve physical function and health-related quality of life (HRQOL) but combinations have not been investigated systematically. The Mental Activity and eXercise (MAX) trial found that mental activity plus exercise over 12 weeks improved cognitive function (primary outcome) in sedentary older adults with cognitive complaints.ObjectiveTo investigate the effects of combinations of two mental activity and exercise programs on physical function and HRQOL (secondary outcomes).MethodsParticipants (n = 126, age 73 ± 6 years, 65% women) were randomized to 12 weeks of exercise (aerobic exercise or stretching/toning, 3 × 60 min/week) plus mental activity (computer-based cognitive training or educational DVDs, 3 × 60 min/week) using a factorial design. Assessments included the Senior Fitness Test (physical function), Short Form-12 physical and mental sub-scales (HRQOL), and CHAMPS questionnaire (physical activity).ResultsThere were no differences between groups at baseline (p > 0.05). We observed improvements over time in most physical function measures [chair stands (p-for-time = 0.001), arm curls (p-for-time < 0.001), step test (p-for-time = 0.003), sit & reach (p-for-time = 0.01), and back scratch (p-for-time = 0.04)] and in physical HRQOL (p-for-time = 0.04). There were no differences in change between groups (group 1 time p > 0.05). Changes in most physical function measures and physical HRQOL correlated with physical activity changes.ConclusionCombined mental activity and exercise interventions of various types can improve both physical function and physical HRQOL among sedentary older adults with cognitive complaints. Exercise control group design should be carefully considered as even light exercise may induce benefits in vulnerable older adults.     

健身运动处方对老年男性身体素质及功能影响的1年随访

目的:分析健身运动处方对老年人体质的影响,为运动干预提供理论依据。方法:于2002-09/2004-09选择鞍山市铁东区和立山区在公共场所常年坚持体育锻炼的男性老年人268人,分为实验组和对照组,实验组134人,实施针对性的运动处方,包括强壮功、保健体操、急走、八段锦、倒退走、自由活动6个项目,对照组134人按习惯锻炼。根据《中国老年人体质调研》测试指标测量实验前后1年参与者的形态类指标、素质类指标及功能类指标的变化情况。结果:实验对象268人均进入结果分析。①素质类指标测试结果:实验后实验组各指标均明显优于对照组,其中握力、摸背、闭眼站立均大于对照组犤(236.28±38.31),(223.67±52.52)N;(-4.56±4.22),(-11.01±4.16)cm;(13.04±5.17),(11.12±8.70)s犦,手眼协调、反应时小于对照组犤(12.07±3.17),(13.08±4.13)s;(0.248±0.042),(0.262±0.082)s犦。②功能类指标测试结果:实验后实验组肺活量大于对照组犤(2132±365),(2020±423)N犦,坐站试验安静心率;运动后即刻10s,60～90s,120～150s,180～210s心率均小于对照组犤(78.63±8.25),(80.21±6.98)次/min;(17.16±5.27),(18.52±4.78)次/10s;(44.17±8.12),(46.63±7.35)次/30s;(42.01±6.78),(43.72±5.67)次/30s;(40.51±6.18),(42.36±7.35)次/30s犦。结论:采用针对性的运动处方,可使老年人的握力、摸背、闭眼站立等各素质类指标及反映呼吸和心血管系统的功能类指标显著改善,从而增强体质。     

Effects of a community-based progressive resistance training program on muscle performance and physical function in adults with Down syndrome: a randomized controlled trial

Shields N, Taylor NF, Dodd KY. Effects of a community-based progressive resistance training program on muscle performance and physical function in adults with Down syndrome: a randomized controlled trial.

Objective

To determine whether progressive resistance training improves muscle strength, muscle endurance, and physical function in adults with Down syndrome.

Design

Single-blind randomized controlled trial.

Setting

General community.

Participants

Adults (N=20) with Down syndrome (13 men, 7 women; mean age, 26.8±7.8y) were randomly assigned through a concealed allocation block randomized method to either an intervention group (n=9) or a control group (n=11).

Intervention

The intervention was a supervised, group progressive resistance training program, consisting of 6 exercises using weight machines performed twice a week for 10 weeks. Participants completed 2 to 3 sets of between 10 to 12 repetitions of each exercise until they reached fatigue. The control group continued with their usual activities.

Main Outcome Measures

The outcomes measured by blinded assessors were muscle strength (1-repetition maximum [1-RM]), muscle endurance (number of repetitions at 50% of 1-RM) for chest press and leg press, timed stairs test, and the grocery shelving task.

Results

The intervention group showed significant improvement in upper-limb muscle endurance compared with the control group (mean difference in the number of repetitions of the chest press at 50% of 1-RM was 16.7, 95% confidence interval, [CI] 7.1-26.2); and a trend toward an improvement in upper-limb muscle strength (mean difference in chest press 1-RM, 8.6kg; 95% CI, −1.3 to 18.5kg) and in upper-limb function (mean difference in grocery shelving task, −20.3s; 95% CI, −45.7 to 5.2s). There were no significant differences between the groups for lower-limb muscle performance or physical function measures. No major adverse events for the intervention were noted.

Conclusions

Progressive resistance training is a safe and feasible fitness option that can improve upper-limb muscle endurance in adults with Down syndrome (ACTR identifier ACTRN 012606000515594.)     

Comparison of methods for determination of testosterone and non-protein bound testosterone in men with alcoholic liver disease

The serum concentrations of testosterone and of non-protein bound testosterone were determined in 28 men with alcoholic liver disease having normal to decreased serum albumin concentrations and normal to raised SHBG concentrations. Serum testosterone concentrations determined with two radioimmunoassays using different purification procedures and antibody batches did not differ significantly and correlated significantly (r=0.91; p less than 0.001). The median serum concentration of non-protein bound testosterone was 0.265 nmol/l (range 0.068-0.495 nmol/l) when determined by equilibrium dialysis and 0.232 nmol/l (range 0.042-0.610 nmol/l) when calculated according to the law of mass action. This difference is insignificant. The concentrations of non-protein bound testosterone determined by the two methods correlated significantly (r=0.83; p less than 0.001). In the calculation of non-protein bound testosterone, the actual serum albumin concentration can be replaced by a fixed albumin concentration (r=0.99; p less than 0.001). Further, in these patients the serum concentration of non-protein bound testosterone can be expressed by the testosterone/SHBG ratio (r=0.97; p less than 0.001).     

A Theory of Mind (TOM) and People with Learning Disabilities: The Effects of a Training Package

Sixteen adults from a local day centre were assessed using a first-order representation of false-belief task (Sally-Ann experiment) for their ‘theory of mind’ abilities (the ability to correctly reason about another's mental state). It was found that only 12.5% of participants could perform this task correctly. The study then went on to establish whether this ability could be trained, retrained and/or transferred. The results showed a significant improvement in participants' performance through training, this improvement was maintained over time and participants appeared to transfer this ability to a similar task. It was concluded that this research puts further doubt on an absence/impaired theory of mind being unique to autism. Implications were discussed in terms of social interaction and people with intellectual disabilities.     

Trial of calcium for preeclampsia prevention (CPEP): Rationale,design, and methods

The results of ten clinical trials suggest that supplemental calcium may prevent preeclampsia. However, methodologic problems and differences in study design limit the acceptance of the results and their relevance to other patient populations. Many of the trials were conducted in countries where, unlike the United States, the usual daily diet contained little calcium. Moreover, none of the trials has reported the outcome of systematic surveillance for urolithiasis, a potential complication of calcium supplementation. In response to the need for a thorough evaluation of the effects of calcium supplementation for the prevention of preeclampsia in the United States, the trial of Calcium for Preeclampsia Prevention (CPEP) was undertaken at five university medical centers. Healthy nulliparous patients were randomly assigned to receive either 2 g supplemental calcium daily (n = 2295) or placebo (n = 2294) in a double-blind study. Study tablets were administered beginning from 13 to 21 completed weeks of gestation and continued until the termination of pregnancy. CPEP employed detailed diagnostic criteria, standardized techniques of measurement, and systematic surveillance for the major study endpoints and for urolithiasis. The nutrient intake of each patient was assessed at randomization and at 32–33 weeks gestation. This report describes the study rationale, design, and methods.     

Effects of androgen replacement therapy on cornea and tear function in men with idiopathic hypogonadotropic hypogonadism

Purpose. Idiopathic hypogonadotropic hypogonadism (IHH) is an endocrine disorder defined with the presence of typical clinical signs and symptoms plus laboratory confirmation of serum testosterone (T) levels lower than 300 ng/dl. Androgen replacement therapy (ART) is the first-step treatment of male IHH. To date, no clinical trial, which investigates the changes on corneal structure and tear function, of systemic ART in men have been published. The objective of this study was to investigate the effects of ART on cornea and tear function in patients with IHH. Materials and methods. This prospective, interventional study was conducted at the Gulhane Military Medical Academy, Ankara, Turkey, a tertiary referral military hospital. Thirty-four eyes of 17 men with IHH patients were evaluated with Schirmer I test, ultrasound pachymeter, applanation tonometer and confocal microscopy. A Testosterone compound (Sustanon® 250 mg) was administered by intramuscular injection in the course of a 3-week period to induce puberty, and human chorionic gonadotropin (Pregnyl® 5000 IU) was administered twice weekly for 3 months to induce fertility. The patients were re-evaluated at the third month of the treatment. Main Outcome Measures were Schirmer score, central corneal thickness (CCT), intraocular pressure (IOP), endothelial cell density, coefficient of variation and cell shape. Results. Schirmer scores showed similar results after the treatment compared to pre-treatment levels (p = 0.14). There was no statistically significant difference in CCT and IOP compared to baseline data (p = 0.96, p = 0.73, respectively), and no significant differences were found in corneal endothelial cell density, percentage of cell size variability or hexagonality (p = 0.83, p = 0.58, p = 0.64, respectively). Conclusions. This is the first study that investigates the effects of ART on corneal structure and tear function in men. ART seems to have no short-term effects on corneal structure and tear function. Further publications of larger, long-term and controlled studies are needed.     

The relationship of reduced peripheral nerve function and diabetes with physical performance in older white and black adults: the Health, Aging, and Body Composition (Health ABC) study

OBJECTIVE—Poor peripheral nerve function is prevalent in diabetes and older populations, and it has great potential to contribute to poor physical performance.RESEARCH DESIGN AND METHODS—Cross-sectional analyses were done for the Health, Aging, and Body Composition (Health ABC) Study participants (n = 2,364; 48% men; 38% black; aged 73–82 years). Sensory and motor peripheral nerve function in legs/feet was assessed by 10- and 1.4-g monofilament perception, vibration detection, and peroneal motor nerve conduction amplitude and velocity. The Health ABC lower-extremity performance battery was a supplemented version of the Established Populations for the Epidemiologic Studies of the Elderly battery (chair stands, standing balance, and 6-m walk), adding increased stand duration, single foot stand, and narrow walk.RESULTS—Diabetic participants had fewer chair stands (0.34 vs. 0.36 stands/s), shorter standing balance time (0.69 vs. 0.75 ratio), slower usual walking speed (1.11 vs. 1.14 m/s), slower narrow walking speed (0.80 vs. 0.90 m/s), and lower performance battery score (6.43 vs. 6.93) (all P < 0.05). Peripheral nerve function was associated with each physical performance measure independently. After addition of peripheral nerve function in fully adjusted models, diabetes remained significantly related to a lower performance battery score and slower narrow walking speed but not to chair stands, standing balance, or usual walking speed.CONCLUSIONS—Poor peripheral nerve function accounts for a portion of worse physical performance in diabetes and may be directly associated with physical performance in older diabetic and nondiabetic adults. The impact of peripheral nerve function on incident disability should be evaluated in older adults.Diabetes is associated with self-reported and objective physical performance measures of functional limitation in U.S. adults (1). Poor peripheral nerve function may play a role in reduced physical function in older diabetic adults (2,3). The incidence (4) and prevalence of poor peripheral nerve function are higher in older adults, even among those without diabetes (4–7). In the U.S. for 1999–2000, 28% of adults aged 70–79 years and 35% of adults aged ≥80 years had peripheral neuropathy based on a simple screen for reduced sensation at the foot (7). We previously found that diabetes was associated with subclinical functional limitation and physical performance in our cohort, although peripheral nerve function measures were not completed then (8).To our knowledge, the relationship of combined sensory and motor peripheral nerve function to objective physical performance has not been investigated in ambulatory, community-dwelling older adults. We evaluated the distribution of sensory and motor peripheral nerve function in older diabetic and nondiabetic adults and the relationship of peripheral nerve function to objective physical performance. We hypothesized that sensory and motor peripheral nerve function explained the relationship of poor physical performance in an older community-based population, both with and without diabetes.     

The Glaucoma Laser Trial (GLT): 3. Design and methods

The Glaucoma Laser Trial (GLT) was an investigator-initiated, grant-supported, multicenter, randomized, controlled clinical trial designed to investigate the efficacy and safety of argon laser trabeculoplasty (ALT) as an alternative to medical treatment for newly diagnosed primary open-angle glaucoma (POAG). One eye of each patient was randomly assigned to ALT followed by medical treatment if needed to control intraocular pressure (IOP). The patient's other eye was assigned to medical treatment. Medical treatment for either eye was prescribed according to a stepped sequence. Patients were followed for a minimum of 2 years. Monitoring for control of IOP and for adherence to the protocol continued throughout the followup period. This article describes the design and methods of the trial and provides a discussion of the underlying rationale for key design decisions.     

The relationship between cognitive and physical function in older adults with rheumatoid arthritis: a literature review

Intact cognitive function is a crucial underpinning for the performance of daily activities in people with chronic diseases, including rheumatoid arthritis (RA). Older adults with RA may have the increased burden of physical function difficulties due to the impact of both age-related cognitive decline and RA-related impairment. Population-based studies reviewed in this article found significant cross-sectional and longitudinal relationships between cognitive function and physical function in older adults with and without comorbid health conditions. Although no study specifically examined this relationship in older adults with RA, interventions designed to enhance functional capacity by minimizing cognitive impairment may benefit older adults with RA. More studies are needed that investigate the relationship between cognitive and physical function in older adults with RA to eventually improve functional status and quality of life.