scholarly journals Gait Speed and Activities of Daily Living Function in Geriatric Patients

1996 ◽  
Vol 20 (1) ◽  
pp. 67
Author(s):  
Trish Hurford
Keyword(s):  
Activities Of Daily Living ◽  
Gait Speed ◽  
Daily Living ◽  
Geriatric Patients

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.

Validation of the NOSGER (Nurses' Observation Scale for Geriatric Patients): Reliability and Validity of a Caregiver Rating Instrument

1996 ◽  
Vol 8 (4) ◽  
pp. 525-547 ◽  
Author(s):  
Margrit Wahle ◽  
Sybille Häller ◽  
René Spiegel
Keyword(s):  
Social Behavior ◽  
Elderly Patients ◽  
Construct Validity ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Geriatric Patients ◽  
Observation Scale ◽  
Depressed Group ◽  
Six Dimensions ◽  
Caregiver Rating

The Nurses' Observation Scale for Geriatric Patients (NOSGER) is a rating scale for use in geriatric patients that can be applied by nurses or other caregivers. It deals with the daily behavior of elderly patients and measures impairment in six areas (dimensions): memory; instrumental activities of daily living (IADL); (basic) activities of daily living (ADL); mood; social behavior; and disturbing behavior. Objectivity, stability, construct validity, and acceptance of the scale have been established in previous studies using an earlier version of the NOSGER. The present validation study considered 50 healthy old subjects, 25 patients with mild dementia, 25 patients with advanced (mostly moderate according to DSM-III-R criteria) dementia, and 25 elderly patients with depression. The NOSGER was completed by relatives in the case of subjects living in their own homes and by nurses or other caregivers for institutionalized subjects. In addition to the NOSGER, selected tests of concentration, memory, and performance were applied as outside criteria.Interrater reliability (objectivity) was estimated by variance component analysis. Values between rtt = .68 and rtt = .89 (all p < .001) were found for the six NOSGER dimensions, the values being higher for the cognitive dimensions (memory, IADL, ADL) than for the noncognitive ones (mood, social behavior, disturbing behavior). Retest realibility (stability), which was calculated via rank order correlations, was somewhat higher for the cognitive NOSGER dimensions (memory rs = .91,IADLrs = .92, ADLrs = .88; p < .001) than for the noncognitive ones (mood rs = .85, social behavior rs = .87, disturbing behavior rs = .84; p < .001). All these values satisfy the level of rtt ≥ .80 required in accordance with psychometric standards. The concurrent validity of the NOSGER dimensions was assessed using correlations with external criteria with which similarity of content was expected. The NOSGER dimensions memory, IADL, ADL, and social behavior were found to correlate closely with external criteria of similar content, whereas no satisfactory concurrent validities were found for the dimensions mood or disturbing behavior. The NOSGER dimensions were also correlated with a number of unrelated external criteria so as to reveal any discordances. For the dimensions memory, IADL, ADL, and social behavior, no clear-cut discriminant validities were found. This suggests that these four dimensions may function as parameters not just of different areas of behavior, but also of a general factor that might be described as “cognitive intactness.” As a further aspect of construct validity, significant differences (all p < .001) between the four groups of subjects were found in five of the six NOSGER dimensions (memory, IADL, ADL, mood, social behavior): The healthy subjects differed significantly from all three patient groups in five of the six dimensions; the moderately demented group differed from the depressed group in four of the six dimensions and from the mildly demented group in two of the six dimensions; and the mildly demented group differed significantly from the depressed group in terms of mood (significance levels are after application of the Bonferroni correction). Significant group differences (p generally < .001) were also found for most of the objective performance tests used (data not presented).

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