scholarly journals Assessment of muscle mass, risk of falls and fear of falling in elderly people with diabetic neuropathy

2015 ◽  
Vol 28 (4) ◽  
pp. 677-683 ◽  
Author(s):  
Hudson Azevedo Pinheiro ◽  
Karla Helena Coelho Vilaça ◽  
Gustavo de Azevedo Carvalho
Keyword(s):  
Diabetic Neuropathy ◽  
Lean Body Mass ◽  
Muscle Mass ◽  
Body Mass ◽  
Fear Of Falling ◽  
Berg Balance Scale ◽  
Elderly Adults ◽  
Risk Of Falling ◽  
Risk Of Falls ◽  
History Of

Abstract Objective : To assess muscle mass, risk of falls and fear of falling in elderly adults with diabetic neuropathy (DNP). Methods : 50 elderly patients with diabetes mellitus (DM) and diabetic neuropathy (NPD) participated in this study. Risk of falling was assessed using the Berg Balance Scale (BBS). Fear of falling was assessed by means of the Falls Efficacy Scale-International (FES-I). Muscle mass was assessed by tetrapolar bioimpedance analysis (BIA) and Janssen's equation. Subjects were divided into two groups: one with a history of falls in the six months before study enrollment (G1) and the other without history of falls (G2). Results : There were statistically significant differences between G1 and G2 regarding lean body mass (p < 0.05), risk of falls as measured by the BBS (p < 0.01), and fear of falling as measured by the FES-I (p < 0.01). In addition, there was a significant correlation between the BBS and BIA (r = 0.45 and p < 0.01), showing that the greater the lean body mass, the lower the risk of falling. Conclusions : We found an association between lean mass, risk of falls and fear of falling in elderly adults with DNP and a history of falls from own height.

scholarly journals Changes in Muscle Mass after Botulinum Toxin Injection in Children with Spastic Hemiplegic Cerebral Palsy

Toxins ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 278
Author(s):  
Dongwoo Lee ◽  
Jaewon Kim ◽  
Ja-Young Oh ◽  
Mi-Hyang Han ◽  
Da-Ye Kim ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Botulinum Toxin ◽  
Lean Body Mass ◽  
Muscle Mass ◽  
Body Mass ◽  
Botulinum Toxin Injection ◽  
Dual Energy ◽  
X Ray ◽  
Hemiplegic Cerebral Palsy

We aimed to evaluate muscle mass changes after injection of botulinum toxin (BoNT) in children with spastic hemiplegic cerebral palsy (CP). Children aged between 2 and 12 years who were diagnosed with hemiplegic CP with spastic equinus foot were prospectively recruited and administered BoNT in the affected leg. Lean body mass (LBM) of both legs and total limbs was measured by dual-energy X-ray absorptiometry (DXA) preinjection and 4 and 12 weeks after injection. A total of 15 children were enrolled into the study. LBM of both legs and total limbs increased significantly over 12 weeks of growth. The ratio of LBM of the affected leg to total limbs and to the unaffected leg significantly reduced at 4 weeks after injection compared with preinjection but significantly increased at 12 weeks after injection compared with 4 weeks after injection. In conclusion, the muscle mass of the affected leg after BoNT injection in children with hemiplegic spastic CP decreased at 4 weeks after BoNT injection but significantly recovered after 12 weeks after injection.

scholarly journals 13 Effects of Benzodiazepines on Orthostatic Blood Pressure in Older People

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii17-iii65
Author(s):  
Giulia Rivasi ◽  
Rose Anne Kenny ◽  
Andrea Ungar ◽  
Roman Romero-Ortuno
Keyword(s):  
Blood Pressure ◽  
Older People ◽  
Fear Of Falling ◽  
Community Dwelling ◽  
University Hospital ◽  
Risk Of Falling ◽  
Non Invasive ◽  
Orthostatic Blood Pressure ◽  
History Of ◽  
The Relationship

Abstract Background Older people taking benzodiazepines (BDZs) have higher risk of falling, which is mainly attributed to unfavorable drug-related effects on cognition and psychomotor functioning. BDZs may also have hypotensive effects, but evidence concerning the relationship between BDZs and orthostatic blood pressure (BP) behaviour in older people is scarce. We investigated the effects of BDZs on BP response to an orthostatic active stand test. Methods We performed a retrospective analysis of data from an outpatient research clinic in an Irish university hospital, where people aged 60 or older underwent a comprehensive geriatric assessment between August 2007 and May 2009. Non-invasive beat-to-beat orthostatic BP was measured during active stand, with systolic BP assessed at each 10-second interval. Information on regular BDZs use was collected. Factors independently associated with orthostatic systolic BP were investigated using multiple linear regression. Results Of 624 community-dwelling people who underwent a clinic assessment, orthostatic active stand data was collected in 541. Information on regular BDZs use was available in 538 people. Of 538 participants, mean age was 72.7±7.2, 67.7% were female and 33 (6.1%) reported regular use of BDZs. History of falls (p=0.027) and fear of falling (p<0.001) were more prevalent in this subgroup. During active stand, participants on BDZs showed a significantly greater systolic BP drop 10 seconds after the posture change (“immediate” BP drop). No significant differences were detected in orthostatic systolic BP in the latter phases of the active stand. After adjusting for possible confounders, BDZs use was independently associated with a mean immediate systolic BP drop of 12 mmHg after standing. Conclusion BDZs may confer higher risk of an immediate systolic BP drop after standing in older people, which may contribute to their known falls risk. BDZ should be avoided in older people at risk of falling.

scholarly journals Correlation of a feline muscle mass score with body composition determined by dual-energy X-ray absorptiometry

2011 ◽  
Vol 106 (S1) ◽  
pp. S57-S59 ◽  
Author(s):  
Kathryn E. Michel ◽  
Wendy Anderson ◽  
Carolyn Cupp ◽  
Dorothy P. Laflamme
Keyword(s):  
Body Composition ◽  
Lean Body Mass ◽  
Muscle Mass ◽  
Body Mass ◽  
Body Fat ◽  
Convergent Validity ◽  
Dual Energy ◽  
Rater Agreement ◽  
Lean Tissue ◽  
X Ray

Body condition scoring (BCS) systems primarily assess body fat. Both overweight and underweight animals may have loss of lean tissue that may not be noted using standard BCS systems. Catabolism of lean tissue can occur rapidly, may account for a disproportionate amount of body mass loss in sick cats and can have deleterious consequences for outcome. Therefore, along with evaluation of body fat, patients should undergo evaluation of muscle mass. The aims of the present study were first to evaluate the repeatability and reproducibility of a 4-point feline muscle mass scoring (MMS) system and second to assess the convergent validity of MMS by dual-energy X-ray absorptiometry (DXA). MMS was as follows: 3, normal muscle mass; 2, slight wasting; 1, moderate wasting; 0, severe wasting. For the first aim, forty-four cats were selected for evaluation based on age and BCS, and for the second aim, thirty-three cats were selected based on age, BCS and MMS. Cats were scored by ten different evaluators on three separate occasions. Body composition was determined by DXA. Inter- and intra-rater agreement were assessed using kappa analysis. Correlation between MMS and BCS, age, percentage lean body mass and lean body mass (LBM) was determined using Spearman's rank-order correlation. The MMS showed moderate inter-rater agreement in cats that scored normal or severely wasted (κ = 0·48–0·53). Intra-rater agreement was substantial (κ = 0·71–0·73). The MMS was significantly correlated with BCS (r 0·76, P < 0·0001), age (r − 0·75, P < 0·0001), LBM (g) (r 0·62, P < 0·0001) and percentage LBM (r − 0·49, P < 0·0035). Additional investigation is needed to determine whether the MMS can be refined and to assess its clinical applicability.

scholarly journals Assessment of Risk Factors for Falls among Patients with Parkinson’s Disease

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Jacek Wilczyński ◽  
Magdalena Ścipniak ◽  
Kacper Ścipniak ◽  
Kamil Margiel ◽  
Igor Wilczyński ◽  
...  
Keyword(s):  
Risk Factors ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
High Risk ◽  
Fear Of Falling ◽  
External Factors ◽  
Low Risk ◽  
Risk Of Falling ◽  
Risk Of Falls ◽  
Risk Factors For Falls

Introduction. The aim of this study was to assess the risk factors for falls in patients with Parkinson’s disease. Materials and Methods. The study comprised 53 participants (52.8% women and 47.2% men). The Hoehn and Yahr 5-point disability scale was used to assess the severity of Parkinson’s disease. The Tinetti Balance and Gait Scale were used to evaluate the risk of falls. The Katz scale was used to test the independence of people with PD. The Falls Efficacy Scale-International Short Form (FES-I) was implemented to assess fear of falling. Results. The majority of participants was at a high risk of falls, being at the same level for women and men. A significant relationship was noted between the risk of falls and subjective assessment of mobility ( χ 2 = 31.86 , p < 0.001 ), number of falls ( χ 2 = 37.92 , p < 0.001 ), independence of the subjects ( χ 2 = 19.28 , p < 0.001 ), type of injury suffered during the fall ( χ 2 = 36.93 , p < 0.001 ), external factors ( χ 2 = 33.36 , p < 0.001 ), and the level of fear of falling ( χ 2 = 8.88 , p < 0.001 ). A significant relationship also occurred between the number of falls and the fear of falling ( χ 2 = 33.49 , p < 0.001 ) and between the number of falls and disease severity ( χ 2 = 45.34 , p < 0.001 ). The applied physiotherapy did not reduce the risk of falls ( χ 2 = 3.18 , p = 0.17 ). Conclusions. Individuals who rated their mobility as good or excellent were at a low risk of falls. People who fell more times were at a high risk of falling. People more independent were at a low risk of falls. Previous injuries were the most associated with being at risk of falling. Uneven surfaces and obstacles on one’s path are the external factors most associated with the risk of falling. People with low levels of fall anxiety were at a low risk of falls. Most people with low fall anxiety have never fallen. Additionally, the majority of patients with stage 1 of the disease have not fallen at all. The reason for the ineffectiveness of physiotherapy may be due to the exercise programs used and the lack of systematic implementation of them. PD is different for each patient; thus, it is important to select individually customized physiotherapy depending on motor and nonmotor symptoms, as well as general health of a patient.

scholarly journals Role of Menopausal Transition and Physical Activity in Loss of Lean and Muscle Mass: A Follow-Up Study in Middle-Aged Finnish Women

2020 ◽  
Vol 9 (5) ◽  
pp. 1588
Author(s):  
Hanna-Kaarina Juppi ◽  
Sarianna Sipilä ◽  
Neil J. Cronin ◽  
Sira Karvinen ◽  
Jari E. Karppinen ◽  
...  
Keyword(s):  
Physical Activity ◽  
Lean Body Mass ◽  
Muscle Mass ◽  
Body Mass ◽  
Muscle Fiber ◽  
Lean Mass ◽  
Menopausal Transition ◽  
Thigh Muscle ◽  
Appendicular Lean Mass ◽  
Early Postmenopause

In midlife, women experience hormonal changes due to menopausal transition. A decrease especially in estradiol has been hypothesized to cause loss of muscle mass. This study investigated the effect of menopausal transition on changes in lean and muscle mass, from the total body to the muscle fiber level, among 47–55-year-old women. Data were used from the Estrogenic Regulation of Muscle Apoptosis (ERMA) study, where 234 women were followed from perimenopause to early postmenopause. Hormone levels (estradiol and follicle stimulating hormone), total and regional body composition (dual-energy X-ray absorptiometry (DXA) and computed tomography (CT) scans), physical activity level (self-reported and accelerometer-measured) and muscle fiber properties (muscle biopsy) were assessed at baseline and at early postmenopause. Significant decreases were seen in lean body mass (LBM), lean body mass index (LBMI), appendicular lean mass (ALM), appendicular lean mass index (ALMI), leg lean mass and thigh muscle cross-sectional area (CSA). Menopausal status was a significant predictor for all tested muscle mass variables, while physical activity was an additional significant contributor for LBM, ALM, ALMI, leg lean mass and relative muscle CSA. Menopausal transition was associated with loss of muscle mass at multiple anatomical levels, while physical activity was beneficial for the maintenance of skeletal muscle mass.

scholarly journals Changes of Functional Ability in Patients With Spinal Cord Injury With and Without Falls During 6 Months After Discharge

2014 ◽  
Vol 94 (5) ◽  
pp. 675-681 ◽  
Author(s):  
Jirabhorn Wannapakhe ◽  
Preeda Arayawichanon ◽  
Jiamjit Saengsuwan ◽  
Sugalya Amatachaya
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Functional Ability ◽  
Fear Of Falling ◽  
Berg Balance Scale ◽  
Physical Activities ◽  
Functional Improvement ◽  
Walk Test ◽  
Cord Injury ◽  
Risk Of Falls

Background Ambulatory patients with spinal cord injury (SCI) encounter a high risk of falls. However, most of the fall data in the literature were subjectively reported, without evidence to confirm the functional ability of those with and without falls. Objectives The purpose of this study was to prospectively evaluate changes in functional ability relating to falls in participants with SCI who fell and those who did not fall during the 6-month period after discharge. Design A 6-month prospective design was used in the study. Method Fifty independent ambulatory participants with SCI were assessed for their functional ability using the Timed “Up & Go” Test, 10-Meter Walk Test, Berg Balance Scale, and Six-Minute Walk Test (6MWT) prior to discharge and 6 months afterward. After discharge, the participants' fall data were monitored monthly to categorize them into faller (≥1 fall in 6 months) and nonfaller (no fall) groups. Results Twenty-seven participants (54%) fell, and their baseline functional abilities were obviously lower than those who did not fall. After 6 months, the functional ability of these participants showed significant improvement for every test, whereas those who did not fall demonstrated a significant improvement only for the 6MWT. After adjusting for the baseline data, the functional ability at 6 months showed no significant differences between the groups. Limitations The study did not monitor physical activities of the participants during the follow-up period. The findings on fear of falling were subjectively reported by the participants. Conclusions Participants with SCI are commonly characterized as being active and enthusiastic, which may drive their physical activities. However, sensorimotor impairments following SCI hinder their ability to move safely, particularly in those with more functional deterioration. Therefore, greater functional improvement is accompanied by a higher risk of falls. Because falls can induce serious consequences, rehabilitation professionals may need to seek strategies to improve safety issues during movement for these patients, particularly in their own environments.

scholarly journals Associations between Daily Movement Distribution, Bone Structure, Falls, and Fractures in Older Adults: A Compositional Data Analysis Study

2021 ◽  
Vol 18 (7) ◽  
pp. 3757
Author(s):  
Ana Moradell ◽  
Irene Rodríguez-Gómez ◽  
Ángel Iván Fernández-García ◽  
David Navarrete-Villanueva ◽  
Jorge Marín-Puyalto ◽  
...  
Keyword(s):  
Older Adults ◽  
Bone Mass ◽  
Cortical Thickness ◽  
Compositional Data ◽  
Fear Of Falling ◽  
Movement Behavior ◽  
Risk Of Falling ◽  
Mineral Density ◽  
Exercise Interventions ◽  
History Of

With aging, bone density is reduced, increasing the risk of suffering osteoporosis and fractures. Increasing physical activity (PA) may have preventive effects. However, until now, no studies have considered movement behaviors with compositional data or its association to bone mass and structure measured by peripheral computed tomography (pQCT). Thus, the aim of our study was to investigate these associations and to describe movement behavior distribution in older adults with previous falls and fractures and other related risk parameters, taking into account many nutritional and metabolic confounders. In the current study, 70 participants above 65 years old (51 females) from the city of Zaragoza were evaluated for the EXERNET-Elder 3.0 project. Bone mass and structure were assessed with pQCT, and PA patterns were objectively measured by accelerometry. Prevalence of fear of falling, risk of falling, and history of falls and fractures were asked through the questionnaire. Analyses were performed using a compositional data approach. Whole-movement distribution patterns were associated with cortical thickness. In regard to other movement behaviors, moderate-to-vigorous PA (MVPA) showed positive association with cortical thickness and total true bone mineral density (BMD) at 38% (all p < 0.05). In addition, less light PA (LPA) and MVPA were observed in those participants with previous fractures and fear of falling, whereas those at risk of falling and those with previous falls showed higher levels of PA. Our results showed positive associations between higher levels of MVPA and volumetric bone. The different movement patterns observed in the groups with a history of having suffered falls or fractures and other risk outcomes suggest that different exercise interventions should be designed in these populations in order to improve bone and prevent the risk of osteoporosis and subsequent fractures.

Comprehensive nutritional assessment of frail older adults and a tailored protein-enhanced diet as a way to improve the nutritional status

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Alina Jaroch ◽  
Mariusz Kozakiewicz ◽  
Alicja Kowalkowska ◽  
Emilia Główczewska-Siedlecka ◽  
Kornelia Kędziora-Kornatowska
Keyword(s):  
Older Adults ◽  
Nutritional Status ◽  
Lean Body Mass ◽  
Muscle Mass ◽  
Physical Performance ◽  
Body Mass ◽  
Nutritional Intervention ◽  
Content Type ◽  
Protein Consumption ◽  
Frail Older Adults

Purpose Frailty is a geriatric syndrome which can be reversible or less severe through appropriate nutritional interventions. In the present study, to test the efficiency of individualized nutritional intervention was conducted a comprehensive assessment of the nutritional status of frail older adults and evaluation of the effect of nutritional intervention on the nutritional status of pre-frail older patients. Design/methodology/approach Frail older adults (n = 43; mean age 84.6 ± 6.4 years old; 81.4% women) had nutritional status assessed using nutritional anthropometry, body composition, and food frequency questionnaire. Pre-frail patients (n = 16; mean age 68.4 ± 5.5 years old; 81.3% women) for eight weeks were consuming 1.0 g protein/kg BW/day. Robust older adults formed a control group (n = 29; mean age 69.3 ± 5.3 years old; 82.8% women). Findings Frail older adults had weight and muscle mass loss, and their diet variety was sufficient. After the intervention, pre-frail patients increased their protein consumption by 25.8% (P = 0.002). An increase in lean body mass (+1.0 kg), skeletal muscle mass (+0.3 kg) and improvement in physical performance was also observed. Originality/value An individual diet for pre-frail older adults can reverse weight loss and increase lean body mass, furthermore preventing or delaying the development of frailty syndrome. Moreover, increased protein consumption improves physical performance of pre-frail older adults.

scholarly journals Dietary protein and exercise for preservation of lean mass and perspectives on type 2 diabetes prevention

2019 ◽  
Vol 244 (12) ◽  
pp. 992-1004
Author(s):  
Maysa Vieira de Sousa ◽  
Diana Bento da Silva Soares ◽  
Elaine Reis Caraça ◽  
Ronaldo Cardoso
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Lean Body Mass ◽  
Muscle Mass ◽  
Body Mass ◽  
Dietary Protein ◽  
The Elderly ◽  
Sarcopenic Obesity ◽  
Nutritional Interventions

Sedentary lifestyle and aging favor the increasing prevalence of obesity and type 2 diabetes and their comorbidities. The loss of lean body mass reduces muscle strength, resulting in impaired functional capacity and leading to increased risks of chronic diseases with advancing age. Besides aging, conditions such as inappetence, social isolation, and inadequate dietary intake cause the loss of lean body mass and increased abdominal fatty mass, resulting in sarcopenic obesity and predisposition to type 2 diabetes. Compared to younger people, this condition is more common in the elderly owing to natural changes in body composition associated with aging. Lifestyle changes such as increased physical activity and improved dietary behaviors are effective for preventing the occurrence of comorbidities. Regarding muscle nutrition, besides caloric adequacy, meeting the requirements for the consumption of dietary amino acids and proteins is important for treating sarcopenia and sarcopenic obesity because muscle tissue mainly consists of proteins and is, therefore, the largest reservoir of amino acids in the body. Thus, this review discusses the effects of dietary protein on the preservation of lean body mass, improvements in the functional capacity of muscle tissue, and prevention of chronic diseases such as type 2 diabetes. In addition, we address the effects of regular physical training associated with dietary protein strategies on lean body mass, body fat loss, and muscle strength in the elderly at a risk for type 2 diabetes development. Impact statement Diabetes mellitus is a worldwide health problem associated with obesity and sedentary lifestyle, which predisposes affected individuals to mortality and morbidity. Additionally, aging and unhealthy lifestyle behaviors increase inflammation and insulin resistance, contributing to the reduction of cytokines related to muscle nutrition and the suppression of lipogenesis, resulting in the development of sarcopenic obesity. One strategy for the prevention of T2D is the avoidance of secondary aging by participating in healthy action programs, including exercise and nutritional interventions. This minireview of several studies demonstrates the impact of physical activity and nutritional interventions on gaining or preserving muscle mass and on the functional aspects of muscles with aging. It provides information on the effect of protein, leucine, β-hydroxy-β-methylbutyrate (HMB), and creatine supplementation on muscle mass, strength, and volume gain and on the prevention of the progressive decrease in muscle mass with aging in combination with maintaining regular physical activity.

Web-based home-hazard modification app for falls prevention: the views of those at risk of falling and their carers

2020 ◽  
Vol 14 (3) ◽  
pp. 141-156
Author(s):  
Nikki Holliday ◽  
Gillian Ward ◽  
Aimee Walker-Clarke ◽  
Rachael Molitor
Keyword(s):  
At Risk ◽  
Online Survey ◽  
Fear Of Falling ◽  
Behavioural Change ◽  
Falls Prevention ◽  
Risk Of Falling ◽  
Content Type ◽  
Risk Of Falls ◽  
Web App ◽  
The Web

Purpose The purpose of the study is to assess the usability and acceptability of FallCheck, a Web app that allows users to complete home-hazard assessments within their own home, with a group of people at risk of falling and their carers. Design/methodology/approach This mixed method study used an online survey followed by semi-structured telephone interviews to collect both qualitative and quantitative data. A Think-Aloud study was used to test usability of the Web app through structured tasks. Findings Findings showed that FallCheck was easy to use with few usability issues. The Web app was deemed appropriate to use by people at risk of falling (young or old) or by carers if appropriate. The depth of knowledge provision and breadth of content was acceptable, and many participants reported subsequently making changes to their home environment to reduce their risk of falling. Overall, the majority of participants reported feelings of improved confidence and safety with an increased awareness of fall risks and a reduction in fear of falling at home. Practical implications FallCheck has good acceptability and usability with people at risk of falling and their carers and has the potential to improve access to home-hazard assessment and affect behavioural change regarding fall risk hazards and behaviour. Originality/value This study describes successful use of an app that may be helpful in identifying home-hazards and making changes to reduce risk of falls, particularly in the absence of occupational therapy intervention and has the potential for integration into falls care pathways.

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