Relationships between balance control and cognitive functions, gait speed, and activities of daily living

2015 ◽  
Vol 49 (5) ◽  
pp. 379-385 ◽  
Author(s):  
Magdaléna Hagovská ◽  
Zuzana Olekszyová
Keyword(s):  
Activities Of Daily Living ◽  
Cognitive Functions ◽  
Gait Speed ◽  
Daily Living ◽  
Balance Control

MO612THE ROLE OF MECHANICAL MUSCLE POWER IN PHYSICAL DYSFUNCTION: A MODEL FOR TAILORING RESISTANCE-BASED REHABILITATION IN CHRONIC KIDNEY DISEASE

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Thomas Wilkinson ◽  
Eleanor Gore ◽  
Jared Palmer ◽  
Luke Baker ◽  
Emma Watson ◽  
...  
Keyword(s):  
Activities Of Daily Living ◽  
Strength Training ◽  
Physical Function ◽  
Muscle Mass ◽  
Gait Speed ◽  
Daily Living ◽  
Muscle Power ◽  
Mechanical Power ◽  
Relative Power

Abstract Background and Aims Individuals living with CKD are characterised by adverse changes in physical function. Knowledge of the factors that mediate impairments in physical functioning is crucial for developing effective interventions that preserve mobility and future independence. Mechanical muscle power describes the rate of performing work and is the product of muscular force and velocity of contraction. Muscle power has been shown to have stronger associations with functional limitations and mortality than sarcopenia in older adults. In CKD, the role of mechanical muscle power is poorly understood and is overlooked as a target in many rehabilitation programmes, often at the expense of muscle mass or strength. The aims of this study were to 1) explore the prevalence of low absolute mechanical power, low relative mechanical power, and low specific mechanical power in CKD; and 2) investigate the association of mechanical power with the ability to complete activities of daily living and physical performance. Method Mechanical muscle power (relative, allometric, specific) was calculated using the sit-to-stand-5 (STS5) test as per previously validated equations. Legs lean mass was derived from regional analyses conducted using bioelectrical impedance analysis (BIA). Physical performance was assessed using two objective tests: usual gait speed and the ‘time-up-and-go’ (TUAG) test. Self-reported activities of daily living (ADLs) were assessed via the Duke Activity Status Index (DASI). Balance and postural stability (postural sway and velocity) was assessed using a FysioMeter. Sex-specific tertiles were used to determine low, medium and high levels of relative STS power and its main components. Results 102 participants with non-dialysis CKD were included (mean age: 62.0 (±14.1) years, n=49 males (48%), mean eGFR: 38.0 (±21.5) ml.min.1.73m2). The mean estimated relative power was 3.1 (±1.5) W.kg in females and 3.3 (±1.3) W.kg in males. Low relative power was found in 35/102 (34%) patients. Relative power was a significant independent predictor of self-reported ADLs (via the DASI) (B=.413, P=.004), and performance on the TUAG (B=-.719, P<.001) and gait speed (B=.404, P=.003) tests. Skeletal muscle mass was not associated with the DASI or any of the objective function tests Conclusion Patients presenting with low muscle power would benefit from participation in appropriate interventions designed to improve the physiological components accounting for low relative muscle power. Assessment of power can be used to tailor renal rehabilitation programmes as shown in Figure 1. Incorporation of power-based training, a novel type of strength training, designed by manipulating traditional strength training variables and primarily movement velocity and training intensity may present the best strategy for improving physical function in CKD.

scholarly journals Mobility improvement in the first 6 postoperative weeks in orthogeriatric fracture patients

2021 ◽  
Author(s):  
Alexander M. Keppler ◽  
Jenny Holzschuh ◽  
Daniel Pfeufer ◽  
Johannes Gleich ◽  
Carl Neuerburg ◽  
...  
Keyword(s):  
Activities Of Daily Living ◽  
Gait Speed ◽  
Daily Living ◽  
Step Length ◽  
Care Hospital ◽  
Self Assessment ◽  
Postoperative Rehabilitation ◽  
Femur Fractures ◽  
Prospective Study Design

Abstract Background Physical activity is a relevant outcome parameter in orthopedic surgery, that can be objectively assessed. Until now, there is little information regarding objective gait parameters in the orthogeriatric population. This study focuses on the first 6 weeks of postoperative rehabilitation, and delivers objective data about gait speed and step length in typical orthogeriatric fracture patterns. Methods Thirty-one orthogeriatric fracture patients [pertrochanteric femur fractures (PFF), femoral neck (FN), and proximal humerus fractures (PHF)] were consecutively enrolled in a maximum care hospital in a prospective study design. All patients wore an accelerometer placed at the waist during the postoperative stay (24 h/d) and at 6-week follow-up, to measure real gait speed and step length. In addition, self-assessment of mobility (Parker mobility score) and activities of daily living (Barthel index) were collected at baseline, during the inpatient stay, and at 6-week follow-up. Results During postoperative hospitalization, significantly higher gait speed (m/s) was observed in the PHF group (0.52 ± 0.27) compared with the FN group (0.36 ± 0.28) and PFF group (0.19 ± 0.28) (p < 0.05). Six weeks postoperatively, gait speed improved significantly in all groups (PHF 0.90 ± 0.41; FN 0.72 ± 0.13; PFF 0.60 ± 0.23). Similarly, step length (m) differed between groups postoperatively [FN 0.16 ± 0.13; PFF 0.12 ± 0.15; PHF 0.31 ± 0.05 (p < 0.005)] and improved over time significantly (FN 0.47 ± 0.01; 0.39 ± 0.19; 0.50 ± 0.18). Self-assessment scores indicate that the majority of the patients had minor restrictions in mobility before the fracture. These values decreased immediately postoperatively and improved in the first 6 weeks, but did not reach the initial level. Conclusions Gait speed, step length, and self-assessment in terms of mobility and activities of daily living improve significantly in the first 6 postoperative weeks in orthogeriatric fracture patients. As very low postoperative mobility during hospitalization was observed, this collective shows great potential in postoperative rehabilitation regardless of their fracture pattern. For this reason, specific aftercare concepts similar to the “fast track” concepts in primary arthroplasty are crucial for orthogeriatric patients in clinical practice. Level of evidence Prospective cohort study, 2.

scholarly journals Impact of Gait Speed and Instrumental Activities of Daily Living on All-Cause Mortality in Adults ≥65 Years With Heart Failure

2015 ◽  
Vol 115 (6) ◽  
pp. 797-801 ◽  
Author(s):  
Alexander X. Lo ◽  
John P. Donnelly ◽  
Gerald McGwin ◽  
Vera Bittner ◽  
Ali Ahmed ◽  
...  
Keyword(s):  
Heart Failure ◽  
Activities Of Daily Living ◽  
Gait Speed ◽  
Daily Living ◽  
Instrumental Activities ◽  
All Cause Mortality

scholarly journals COMPARATIVE PERFORMANCE OF FOUR CLAIMS-BASED FRAILTY MEASURES IN THE UNITED STATES MEDICARE DATA

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S684-S685
Author(s):  
Dae H Kim ◽  
Elisabetta Patorno ◽  
Ajinkya Pawar ◽  
Hemin Lee ◽  
Sebastian Schneeweiss ◽  
...  
Keyword(s):  
United States ◽  
Health Outcomes ◽  
Activities Of Daily Living ◽  
Gait Speed ◽  
Daily Living ◽  
Correlation Coefficients ◽  
The United States ◽  
Medicare Data ◽  
C Statistic ◽  
Age And Sex

Abstract Background: There has been increasing effort to measure frailty in the United States Medicare data. The performance of claims-based frailty measures has not been compared. Methods: This retrospective cohort study included 2,326 community-dwelling Medicare beneficiaries who participated in the 2008 assessment of the Health and Retirement Study. The claims-based frailty measures developed by Davidoff, Faurot, Segal, and Kim were compared against clinical measures of frailty (gait speed, grip strength) using correlation coefficients and health outcomes (e.g., mortality, hospitalization, activities-of-daily-living disabilities) over 2 years using C-statistics. Results: The Davidoff, Faurot, Segal, and Kim indices were negatively correlated with gait speed (-0.19, -0.33, -0.37, and -0.37, respectively), but age and sex adjustment variably attenuated the correlation to -0.17, -0.22, -0.18, and -0.33, respectively. The corresponding correlation coefficients with grip strength were -0.17, -0.27, -0.35, and -0.24, which attenuated to -0.09, -0.14, -0.05, and -0.23 after age and sex adjustment, respectively. The models that included age, sex, and each of Davidoff, Faurot, Segal, and Kim indices showed C-statistics of 0.67, 0.71, 0.71, 0.75 for mortality (versus C-statistic for age and sex: 0.66); 0.59, 0.64, 0.63, 0.70 for hospitalization (versus C-statistic for age and sex: 0.58); and 0.64, 0.63, 0.63, 0.70 for activities-of-daily-living disabilities (versus C-statistic for age and sex: 0.61), respectively. Conclusions: The choice of a claims-based frailty measure results in a meaningful variation in the identification of frail older adults at high risk for adverse health outcomes. Claims-based frailty measures that included demographic variables offer limited risk adjustment beyond age and sex.

scholarly journals Identifying Early Decline of Physical Function in Community-Dwelling Older Women: Performance-Based and Self-Report Measures

2002 ◽  
Vol 82 (4) ◽  
pp. 320-328 ◽  
Author(s):  
Jennifer S Brach ◽  
Jessie M VanSwearingen ◽  
Anne B Newman ◽  
Andrea M Kriska
Keyword(s):  
Activities Of Daily Living ◽  
Physical Function ◽  
Older Women ◽  
Gait Speed ◽  
Daily Living ◽  
Performance Test ◽  
Social Activity ◽  
Community Dwelling ◽  
Self Report ◽  
Functional Status Questionnaire

Abstract Background and Purpose. The ability to identify early decline in physical function is important, but older people experiencing decline may fail to report the early changes in physical function. The purpose of this study was to compare the descriptions of physical function in community-dwelling older women obtained using performance-based and self-report measures. Subjects and Methods. One hundred seventy community-dwelling women with a mean age of 74.3 years (SD=4.3, range=56.6–83.6) completed the activities of daily living (ADL), instrumental activities of daily living (IADL), and social activity (SA) sections of the Functional Status Questionnaire (FSQ). They also completed performance-based measures of gait speed and the 7-item Physical Performance Test (PPT). Results. The majority of the women scored at the ceiling for the self-report measures of function (ADL=77%, IADL=61%, SA=94%), whereas only 7% scored at the ceiling for the PPT and 30% scored at the ceiling for gait speed (defined as &gt;1.2 m/s). For 2 items of the FSQ, sensitivity was low (8% and 9%) and specificity was high (97% and 98%) compared with performance on the PPT. Discussion and Conclusion. In this sample of community-dwelling older women, performance-based measures identified more limitations in physical function than did self-report measures.

scholarly journals Gait Speed and Instrumental Activities of Daily Living in Older Adults After Hospitalization: A Longitudinal Population-Based Study

2021 ◽  
Author(s):  
Juraj Sprung ◽  
Mariana Laporta ◽  
David S Knopman ◽  
Ronald C Petersen ◽  
Michelle M Mielke ◽  
...  
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Functional Status ◽  
Gait Speed ◽  
Daily Living ◽  
Functional Limitations ◽  
Parameter Estimate ◽  
Population Based ◽  
Instrumental Activities

Abstract Background Hospitalization can impair physical and functional status of older adults, but it is unclear whether these deficits are transient or chronic. This study determined the association between hospitalization of older adults and changes in long-term longitudinal trajectories of two measures of physical and functional status: gait speed (GS) and Instrumental Activities of Daily Living measured with Functional Activities Questionnaire (FAQ). Methods Linear mixed effects models assessed the association between hospitalization (non-elective vs. elective, and surgical vs. medical) and outcomes of GS and FAQ score in participants (&gt;60 years old) enrolled in the Mayo Clinic Study of Aging who had longitudinal assessments. Results Of 4,902 participants, 1,879 had ≥1 hospital admission. Median GS at enrollment was 1.1 m/s. The slope of the annual decline in GS before hospitalization was -0.015 m/s. The parameter estimate [95%CI] for additional annual change in GS trajectory after hospitalization was -0.009 [-0.011 to -0.006] m/s, P&lt;0.001. The accelerated GS decline was greater for medical vs. surgical hospitalizations (-0.010 vs. -0.003 m/s, P=0.005), and non-elective vs. elective hospitalizations (-0.011 vs -0.006 m/s, P=0.067). The odds of a worsening FAQ-score increased on average by 4% per year. Following hospitalization, odds of FAQ-score worsening further increased (multiplicative annual increase in odds ratio per year [95%C] following hospitalization was 1.05 [1.03, 1.07], P&lt;0.001). Conclusions Hospitalization of older adults is associated with accelerated long-term decline in GS and functional limitations, especially after non-elective admissions and those for medical indications. However, for most well-functioning participants these changes have little clinical significance.

scholarly journals Associations Between Self- and Informant-Reported Abilities of Instrumental Activities of Daily Living and Cognitive Functions in Older Adults With Mild Cognitive Impairment

2020 ◽  
Author(s):  
Xin Zhao ◽  
Wenjia Liang ◽  
Joseph H R Maes
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Activities Of Daily Living ◽  
Cognitive Processing ◽  
Processing Speed ◽  
Cognitive Functions ◽  
Daily Living ◽  
Instrumental Activities ◽  
Cognitive Processing Speed

Abstract Objective Older adults (OAs) with mild cognitive impairment (MCI) show disabilities in instrumental activities of daily living (IADLs), which have been linked to compromised cognitive functioning. However, it is unclear which cognitive functions are primarily involved. The present study sought to identify the cognitive function(s) most strongly associated with the IADL limitations in MCI. Method OAs with MCI (N = 120) completed cognitive tasks measuring general cognitive processing speed, working memory (WM) maintenance and updating, inhibition, and shifting ability. IADL abilities were assessed through both self- and informant reports. Results Self-reported IADL abilities were positively associated with both cognitive processing speed and WM updating capacity. Informant-reported IADL abilities were also positively associated with processing speed and WM updating, in addition to cognitive shifting ability. Conclusion Both general processing speed and WM updating capacity were consistently predictive of IADL abilities. These results might inform the design of training programs aimed at maintaining or improving functional independence in individuals with MCI to focus more on these cognitive functions. However, the strength of the association between specific cognitive functions and IADL abilities in OAs with MCI depends on the source of the information about the IADL abilities, which highlights the need for gathering data from both the examinee and informants.

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