Assessing fatigability with the five chair rise test in Parkinson patients and older adults using a wearable sensor

AbstractDuring and after hospitalisation, older adults are recommended to consume 1·2–1·5 g of protein/kg body weight per d (g/kg per d) to improve recovery. This randomised controlled trial studied the effectiveness of a 12-week intervention with protein-enriched foods and drinks by following-up seventy-five older patients (mean age: 76·8 (sd 6·9) years) during their first 6 months after hospital discharge. Primary outcomes were protein intake and physical performance (measured with Short Physical Performance Battery (SPPB)). Secondary outcomes for physical recovery were gait speed, chair-rise time, leg-extension strength, hand-grip strength, body weight, nutritional status (Mini Nutritional Assessment), independence in activities of daily living (ADL) and physical activity. The intervention group consumed more protein during the 12-week intervention period compared with the control group (P<0·01): 112 (sd 34) g/d (1·5 (sd 0·6) g/kg per d) v. 78 (sd 18) g/d (1·0 (sd 0·4) g/kg per d). SPPB total score, gait speed, chair-rise time, body weight and nutritional status improved at week 12 compared with baseline (time effect P<0·05), but were not different between groups. Leg-extension strength, hand-grip strength and independence in ADL did not change. In conclusion, protein-enriched products enabled older adults to increase their protein intake to levels that are higher than their required intake. In these older adults with already adequate protein intakes and limited physical activity, protein enrichment did not enhance physical recovery in the first 6 months after hospital discharge.

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Foot Problems in Older Adults

Journal of the American Podiatric Medical Association ◽

10.7547/15-186 ◽

2018 ◽

Vol 108 (2) ◽

pp. 126-139 ◽

Cited By ~ 15

Author(s):

Amy Muchna ◽

Bijan Najafi ◽

Christopher S. Wendel ◽

Michael Schwenk ◽

David G. Armstrong ◽

...

Keyword(s):

Older Adults ◽

Peripheral Neuropathy ◽

Motor Performance ◽

Fear Of Falling ◽

Center Of Mass ◽

Community Dwelling ◽

Lower Percentage ◽

Wearable Sensor ◽

Eyes Open ◽

Foot Problems

Background:Research on foot problems and frailty is sparse and could advance using wearable sensor–based measures of gait, balance, and physical activity (PA). This study examined the effect of foot problems on the likelihood of falls, frailty syndrome, motor performance, and PA in community-dwelling older adults.Methods:Arizona Frailty Cohort Study participants (community-dwelling adults aged ≥65 years without baseline cognitive deficit, severe movement disorders, or recent stroke) underwent Fried frailty and foot assessment. Gait, balance (bipedal eyes open and eyes closed), and spontaneous PA over 48 hours were measured using validated wearable sensor technologies.Results:Of 117 participants, 41 (35%) were nonfrail, 56 (48%) prefrail, and 20 (17%) frail. Prevalence of foot problems (pain, peripheral neuropathy, or deformity) increased significantly as frailty category worsened (any problem: 63% in nonfrail, 80% in prefrail [odds ratio (OR) = 2.0], and 95% in frail [OR = 8.3]; P = .03 for trend) due to associations between foot problems and both weakness and exhaustion. Foot problems were associated with fear of falling but not with fall history or incident falls over 6 months. Foot pain and peripheral neuropathy were associated with lower gait speed and stride length; increased double support time; increased mediolateral sway of center of mass during walking, age adjusted; decreased eyes open sway of center of mass and ankle during quiet standing, age adjusted; and lower percentage walking, percentage standing, and total steps per day.Conclusions:Foot problems were associated with frailty level and decreased motor performance and PA. Wearable technology is a practical way to screen for deterioration in gait, balance, and PA that may be associated with foot problems. Routine assessment and management of foot problems could promote earlier intervention to retain motor performance and manage fear of falling in older adults, which may ultimately improve healthy aging and reduce risk of frailty.

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Effects of Lower Extremity Strength Training on Functional Mobility in Older Adults

Journal of Aging and Physical Activity ◽

10.1123/japa.8.3.214 ◽

2000 ◽

Vol 8 (3) ◽

pp. 214-227 ◽

Cited By ~ 43

Author(s):

L. Jerome Brandon ◽

Lisa W. Boyette ◽

Deborah A. Gaasch ◽

Adrienne Lloyd

Keyword(s):

Older Adults ◽

Lower Extremity ◽

Strength Training ◽

Relative Strength ◽

Functional Mobility ◽

Knee Extensors ◽

Plantar Flexors ◽

Lower Extremity Strength ◽

Time Required ◽

Chair Rise

This study evaluated the effects of a 4-month lower extremity strength-training program on mobility in older adults. Eighty-five older adults (43 experimental, ES, and 42 comparison, CS) with a mean age of 72.3 years served as participants. The ES strength-trained plantar flexors (PF), knee flexors (KF), and knee extensors (KE) 1 hr/day, 3 days a week for 4 months. Both the ES and CS were evaluated for PF, KF, and KE strength (1 RM) and the time required to complete floor rise, chair rise, 50-ft walk, and walking up and down stairs before and after the training intervention. The ES increased (p < .05) both absolute (51.9%) and relative strength (1 RM/body weight, 52.4%) after training. Only chair-rise and floor-rise tasks improved significantly after training. Baseline and posttraining mobility tasks predicted from 1 RMs had low to moderate R values. These results suggest that strength is necessary for mobility, but increasing strength above baseline provides only marginal improvement in mobility for reasonably fit older adults.

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Quantitative mobility metrics from a wearable sensor predict incident parkinsonism in older adults

Parkinsonism & Related Disorders ◽

10.1016/j.parkreldis.2019.06.012 ◽

2019 ◽

Vol 65 ◽

pp. 190-196 ◽

Cited By ~ 3

Author(s):

Rainer von Coelln ◽

Robert J. Dawe ◽

Sue E. Leurgans ◽

Thomas A. Curran ◽

Timothy Truty ◽

...

Keyword(s):

Older Adults ◽

Wearable Sensor

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Effect of wearable sensor-based Otago Exercise Program biofeedback in older adults with moderate to high risk of falling

European Journal of Public Health ◽

10.1093/eurpub/ckaa040.003 ◽

2020 ◽

Vol 30 (Supplement_2) ◽

Author(s):

A C Martins ◽

D Francisco ◽

D Guia

Keyword(s):

Older Adults ◽

High Risk ◽

Real Time ◽

Self Efficacy ◽

Exercise Program ◽

Step Test ◽

Control Group ◽

Wearable Sensor ◽

Post Intervention ◽

Significant Difference

Abstract Introduction Falls remain a major public health issue. The ageing process is characterized by a progressive decrease in muscle strength, reaction time, postural control and changes in sensory systems. Wearable sensor-based biofeedback systems used in physiotherapy, particularly incorporated in exercise programs, are promising strategies to enhance the learning of strength and balance exercises and improve self-efficacy. Objectives To evaluate the effect of the wearable sensor-based Otago Exercise Program (OTAGO) biofeedback in older adults with moderate to high risk. Methodology Sixty participants (84.35 years) were distributed to the experimental group (26) and a control group (34). The EG underwent the OTAGO incorporated in a technological system using pressure and inertial sensors and biofeedback in real-time, administered by a physiotherapist for 5 weeks, with a frequency of 2 times a week. The CG kept doing their regular activities. Outcome measures included handgrip strength (HG), Time Up and Go (TUG), 30 seconds Sit to Stand, 10 meters Walking Speed (10m WS), 4 Stage Balance Test “Modified”, Step test and Questionnaire of Self-efficacy for exercise. Results At baseline, significant differences were observed regarding the 10m WS (p < 0.001), TUG (p = 0.036) and HG (p = 0.001). Relatively to 4SBTM, in post-intervention was seen significant difference (p = 0.008) and in EG there was also substantial results (p < 0.001). The same happens in SEE (p = 0.013 and p = 0.020, respectively). A significant increase was found in EG so that the post-intervention 10m WS was statistically higher compared with the CG (EG: 0.42±0.29; CG: 1.10±0.51; p = 0.003). In the CG worst results were observed in some of the functional tests. Conclusion Biofeedback in real-time facilitates the self-learning of the exercise program, and it is a useful tool for training strength, balance and self-efficacy for exercise, contributing to reducing the risk of falls.

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Motor unit activity, force steadiness, and perceived fatigability are correlated with mobility in older adults

Journal of Neurophysiology ◽

10.1152/jn.00192.2018 ◽

2018 ◽

Vol 120 (4) ◽

pp. 1988-1997 ◽

Cited By ~ 9

Author(s):

Diba Mani ◽

Awad M. Almuklass ◽

Landon D. Hamilton ◽

Taian M. Vieira ◽

Alberto Botter ◽

...

Keyword(s):

Older Adults ◽

Muscle Activation ◽

Motor Units ◽

Lower Leg ◽

Discharge Characteristics ◽

Healthy Older Adults ◽

Force Steadiness ◽

Leg Muscles ◽

Chair Rise ◽

Walking Endurance

The purpose of our study was to examine the associations between the performance of older adults on four tests of mobility and the physical capabilities of the lower leg muscles. The assessments included measures of muscle strength, muscle activation, and perceived fatigability. Muscle activation was quantified as the force fluctuations—a measure of force steadiness—and motor unit discharge characteristics of lower leg muscles during submaximal isometric contractions. Perceived fatigability was measured as the rating of perceived exertion achieved during a test of walking endurance. Twenty participants (73 ± 4 yr) completed one to four evaluation sessions that were separated by at least 3 wk. The protocol included a 400-m walk, a 10-m walk at maximal and preferred speeds, a chair-rise test, and the strength, force steadiness, and discharge characteristics of motor units detected by high-density electromyography of lower leg muscles. Multiple-regression analyses yielded statistically significant models that explained modest amounts of the variance in the four mobility tests. The variance explained by the regression models was 39% for 400-m walk time, 33% for maximal walk time, 42% for preferred walk time, and 27% for chair-rise time. The findings indicate that differences in mobility among healthy older adults were partially associated with the level of perceived fatigability (willingness of individuals to exert themselves) achieved during the test of walking endurance and the discharge characteristics of soleus, medial gastrocnemius, and tibialis anterior motor units during steady submaximal contractions with the plantar flexor and dorsiflexor muscles. NEW & NOTEWORTHY Differences among healthy older adults in walking endurance, walking speed, and ability to rise from a chair can be partially explained by the performance capabilities of lower leg muscles. Assessments comprised the willingness to exert effort (perceived fatigability) and the discharge times of action potentials by motor units in calf muscles during submaximal isometric contractions. These findings indicate that the nervous system contributes significantly to differences in mobility among healthy older adults.

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