Impact of Physical Activities on Frailty in Community-Dwelling Older Women

Aims: The aim of the study was to determine whether increased physical activities (PA) affect frailty for old women, 75 years and older (OO), compared to 60–74 years old (YO). Methods: This cross-sectional study measured 19 frailty indicators (muscle strength and endurance, balance, gait characteristics, and function), using 46 community-dwelling women. PA were divided into three levels by caloric expenditure per week (<2,000 kcal/week, 2,000–3,999 kcal/week, >4,000 kcal/week). Results: As PA level increased, a gap (=difference) between OO and YO narrowed for step length and function, but for quadriceps strength and endurance, a gap widened. Conclusions: Frailty progresses with aging but older women who engage in a high level of physical activity (>4,000 kcal/week) can increase mobility and functional capacity, but not for muscle strength and endurance. Starting regular resistance training activities early in the aging process is critical to improve or maintain muscle quality to offset age-related frailty.     

Analyse vidéographique 2D d’exercices fonctionnels avec déplacements verticaux et mesure de la force musculaire isocinétique du genou après ligamentoplastie du ligament croisé antérieur

Introduction

After anterior cruciate ligament (ACL) ligamentoplasty, muscular recovery is often compared to asymmetries in monopodal length jumps, but rarely to functional exercises with vertical displacements. The objective of this study is to analyze these asymmetries and to determine the correlations with the muscular force.

Effects of controlled whole-body vibration training in improving fall risk factors among individuals with multiple sclerosis: A pilot study

Purpose: The purpose of this study was to systematically examine the effect of an 8-week controlled whole-body vibration training on improving fall risk factors and the bone mineral density among people with multiple sclerosis (PwMS).

Methods: This study adopted a single group pre-test–post-test design. Twenty-five PwMS (50.3 years SD 14.1) received vibration training on a side-alternating vibration platform. Each training session was repeated three times every week for 8 weeks. Prior to and following the 8-week training course, a battery of fall risk factors were evaluated: the body balance, functional mobility, muscle strength, range of motion, and fear of falling. Bone density at both calcanei was also assessed.

Results: Twenty-two participants completed the study. Compared with pre-test, almost all fall risk factors and the bone density measurement were significantly improved at post-test, with moderate to large effect sizes varying between 0.571 and 1.007.

Conclusions: The 8-week vibration training was well accepted by PwMS and improved their fall risk factors. The important findings of this study were that vibration training may increase the range of motion of ankle joints on the sagittal plane, lower the fear of falling, and improve bone density.

• IMPLICATIONS FOR REHABILITATION

• An 8-week vibration training course could be well-accepted by people with multiple sclerosis (MS).

• Vibration training improves the risk factors of falls in people living with MS.

• Vibration training could be a promising rehabilitation intervention in individuals with MS.

     

Functional factors that are important correlates to physical activity in people with multiple sclerosis: a pilot study

Purpose: Identify functional factors that are important correlates to physical activity levels among people with multiple sclerosis.

Methods: A total of eight functional tests were conducted and physical activity was objectively measured (Actigraph GT3X accelerometer) for one week in 34 people with multiple sclerosis. A corrected Akaike Information Criterion analysis was performed to identify the strongest correlates with moderate-to-vigorous physical activity, total activity and sedentary time.

Results: The multiple regression analysis converged on a model for moderate-to-vigorous physical activity (R²?=?0.31, F?=?6.97, p=?0.003) that included total strength of the less-affected leg (partial r?=?0.46, p?=?0.007) and average peg test performance (partial r?=??0.30, p?=?0.087). The model for total activity (R²?=?0.40, F?=?10.51, p?<?0.001) included five times sit-to-stand performance (partial r=??0.44, p?=?0.010) and total strength of the less-affected leg (partial r?=?0.31, p?=?0.077). The model for sedentary time (R²=0.22, F?=?9.23, p?=?0.005) only included total strength of the more affected leg (r=??0.47, p?=?0.005).

Conclusion: These results suggest that leg strength, manual dexterity and the ability to perform functional tasks may be important correlates with physical activity levels in people with multiple sclerosis. The findings of this pilot study can inform future investigations aiming to increase physical activity levels or develop improved rehabilitation protocols for people with multiple sclerosis.

• Implications for Rehabilitation

• Physical activity is an effective means of improving the symptoms associated with multiple sclerosis.

• Participation in physical activity by people with multiple sclerosis may be affected by functional factors such as leg strength, manual dexterity and the ability to rise from a seated position.

• Bilateral leg strength differences should be assessed and addressed in people with multiple sclerosis.

     

Lean Body Mass Associated with Upper Body Strength in Healthy Older Adults While Higher Body Fat Limits Lower Extremity Performance and Endurance

Impaired strength adversely influences an older person’s ability to perform activities of daily living. A cross-sectional study of 117 independently living men and women (age = 73.4 ± 9.4 year; body mass index (BMI) = 27.6 ± 4.8 kg/m²) aimed to assess the association between body composition and: (1) upper body strength (handgrip strength, HGS); (2) lower extremity performance (timed up and go (TUG) and sit to stand test (STS)); and (3) endurance (6-minute walk (SMWT). Body composition (% fat; lean body mass (LBM)) was assessed using bioelectrical impedance. Habitual physical activity was measured using the Minnesota Leisure Time Physical Activity Questionnaire (MLTPA) and dietary macronutrient intake, assessed using 24 h recalls and 3-day food records. Regression analyses included the covariates, protein intake (g/kg), MLTPA, age and sex. For natural logarithm (Ln) of right HGS, LBM (p < 0.001) and % body fat (p < 0.005) were significant (r² = 46.5%; p < 0.000). For left LnHGS, LBM (p < 0.000), age (p = 0.036), protein intake (p = 0.015) and LnMLTPA (p = 0.015) were significant (r² = 0.535; p < 0.000). For SMW, % body fat, age and LnMLTPA were significant (r² = 0.346; p < 0.000). For STS, % body fat and age were significant (r² = 0.251; p < 0.000). LBM is a strong predictor of upper body strength while higher % body fat and lower physical activity are associated with poorer outcomes on tests of lower extremity performance.     

CT评价腹股沟疝患者肌肉质量方法的前瞻性研究

目的　应用CT技术评价老年腹股沟疝患者的肌肉质量。方法　拟接受腹股沟疝手术、年龄在70~90岁的男性住院患者30例为研究对象,40~50岁10名男性健康受试者为成人对照组,10名同年龄段接受健康查体老年人为老年对照组,记录一般资料,应用CT技术扫描腹部和大腿,通过专用软件计算相应肌肉面积。结果　研究组握力（36.44±14.15）kg明显少于成人对照组（77.30±22.69）kg （P=0.001）,研究组小腿围（25.18±2.31）cm 明显少于成人对照组（27.62±2.33）cm （P=0.006）。CT扫描显示研究组与成人对照组L3（第3腰椎）平面腹部面积、皮下脂肪面积、腹腔脂肪面积和竖脊肌总面积相近,研究组腹部肌肉面积（12 094.23±1 970.30）mm2和竖脊肌肌肉面积（1 642.60±266.90）mm2明显少于成人对照组的（17 462.00±1 600.58）mm2和（2 003.50±350.91）mm2（P=0.001, P=0.007）。L3骨骼肌指数为50.64±7.52,存在肌肉减少症（≤52.4）为66.7 %（20/30）。与同年龄正常查体老人腹部肌肉CT结果相似。研究组下肢骨骼肌面积明显少于成人对照组（P=0.001）,下肢脂肪和股骨面积两组比较差异无统计学意义（P＞0.05）。结论　老年腹股沟疝患者肌肉质量和力量明显低于成人对照组,CT技术可作为评价工具。     

Hip adduction strength and provoked groin pain: A comparison of long-lever squeeze testing using the ForceFrame and the Copenhagen 5-Second-Squeeze test

ObjectivesTo compare long-lever squeeze testing using the ForceFrame and the Copenhagen 5-Second-Squeeze test (5SST) for assessment of hip adduction strength and provoked groin pain in elite male soccer players.DesignCross-sectional study.SettingPre-season testing at facilities of a Danish professional 1^st tier soccer club and academy.ParticipantsElite male soccer players (n = 83, mean age; 16 ± 2.7 years) from U13, U14, U15, U17, U19 and senior teams cleared for full training and match participation.Main outcome measuresMaximum isometric hip adduction strength (Nm/kg) and provoked groin pain (NRS 0–10).ResultsHip adduction strength was 16% lower in the ForceFrame. A Bland-Altman plot showed a systematic bias (−0.47 Nm/kg, 95% CI [-0.57; −0.38]) and lack of agreement (95% limits of agreement: -1.31; 0.39 Nm/kg). In the ForceFrame, provoked groin pain was less intense (median NRS 0 [IQR: 0–1] vs. 5SST: 1 [IQR: 0–3], p < 0.001) and reported by fewer players (NRS >0) (27% [n = 22] vs. 5SST: 61.4% [n = 51], p < 0.001).ConclusionsThe ForceFrame and the 5SST lack agreement and are not interchangeable methods. This may have implications when selecting a method for screening and detecting early groin problems in male soccer players.     

Handgrip Strength is an Independent Predictor of Distal Radius Bone Mineral Density in Postmenopausal Women

Several cross-sectional studies have reported a positive correlation between muscle strength and local bone mineral density. However, very few studies have evaluated the possible role of confounding variables, which may be substantial as both bone mineral density and muscle strength are multifactorial variables. We studied 140 postmenopausal women who underwent their first osteodensitometry in our hospital. Of these, 102 women affected neither by bone diseases apart from primary osteoporosis nor treated with drugs affecting bone mass were selected. Distal radius bone mineral density of the non-dominant arm was assessed by dual photon absorptiometry. Handgrip strength was measured by a handheld dynamometer. The following factors influencing bone mass were also considered: age, years since menopause, years of cyclic ovarian activity, body weight, body height, body mass index, and both calcium and alcohol dietary intake. Statistical evaluation was performed by stepwise multiple regression analysis. This showed that only two variables were independently related to bone mineral density: handgrip strength (which was the best bone density predictor among the studied independent variables) and years since menopause. R² value was 0.43 (F=38.04, p<0.001). All the other variables studied were not significantly related to bone density when the effects of both strength and years since menopause were considered. In conclusion, the data showed that handgrip strength was a strong independent predictor of distal radius bone mineral density in postmenopausal women. Clinical assessment of osteoporosis risk factors, including muscle strength, is recommended: although it is not an adequate substitute for bone densitometry, it can help clinicians to identify the risk groups at which to direct bone density measurement. Received: 1 October 1999 / Accepted: 29 May 2000     

The relationship between lower body strength and obstructed gait in community-dwelling older adults

OBJECTIVES: To determine the relationship between lower body strength of community-dwelling older adults and the time to negotiate obstructed gait tasks. DESIGN: A correlational study. SETTING: The Biomechanics Laboratory, Deakin University, Australia. PARTICIPANTS: Twenty-nine women and 16 men aged 62 to 88 were recruited using advertisements placed in local newspapers. The participants were independent community dwellers, healthy and functionally mobile. MEASUREMENTS: Maximal isometric strength of the knee extensors and dynamic strength of the hip extensors, hip flexors, hip adductors, hip abductors, knee extensors, knee flexors, and ankle plantar flexors were assessed. The times to negotiate four obstructed gait tasks at three progressively challenging levels on an obstacle course and to complete the course were recorded. The relationship between strength and the crossing times was explored using linear regression models. RESULTS: Significant associations between the seven strength measures and the times to negotiate each gait task and to walk the entire course at each level were obtained (r = -0.38 to -0.55; P < .05). In addition, the percentage of the variance explained by strength (R(2)), consistently increased as a function of the progressively challenging level. This increase was particularly marked for the stepping over task (R(2) = 19.3%, 25.0%, and 27.2%, for levels 1, 2, and 3, respectively) and the raised surface condition (R2 = 17.1%, 21.1%, and 30.8%, for levels 1, 2, and 3, respectively). CONCLUSION: The findings of the study showed that strength is a critical requirement for obstructed locomotion. That the magnitude of the association increased as a function of the challenging levels suggests that intervention programs aimed at improving strength would potentially be effective in helping community-dwelling older adults negotiate environmental gait challenges.     

Building trophic modules into a persistent food web

Understanding what maintains species and perpetuates their coexistence in a network of feeding relationships (the food web) is of great importance for biodiversity conservation. A food web can be viewed as consisting of a number of simple subunits called trophic modules. Intraguild predation (IGP), in which a prey and its predator compete for the same resource, is one of the best-studied trophic modules. According to theory, there are two ways to yield a large persistent system from such modules: (i) to use persistent subunits as building blocks or (ii) to arrange the subunits in a way that externally supports the nonpersistent subunits. Here, I show that the complex food web of the Caribbean marine ecosystem is constructed in both ways. I show that IGP modules, which convey internal persistence because of the fact that prey are superior competitors for the resources, are overrepresented in the Caribbean ecosystem. The other modules, consisting of competitively inferior prey, are not persistent in isolation. However, competitively inferior prey in these modules tend to receive more advantage from extra-module interactions, which allows persistence of the IGP module. In addition, those exterior interactions tend to be provided by intrinsically persistent IGP modules to prevent cascading extinction of interacting IGP modules. The food web can be viewed as a set of interacting modules, nonrandomly arranged to enhance the maintenance of biodiversity.