The Added Value of Combined Timed Up and Go Test, Walking Speed, and Grip Strength on Predicting Recurrent Falls in Chinese Community-dwelling Elderly

Abstract Background; Osteoporosis and related fractures, a worldwide public health issue of growing concern, is characterized by compromised bone strength and an increased risk of fracture. Here we show an association between self-reported walking speed and bone mass among community-dwelling postmenopausal Japanese women aged 50 years and older.Design; Cross-sectional study.Setting and Participants; The survey population included 1008 postmenopausal women 50–92 years of age residing in rural communities.Methods; Self-reported walking speed was ascertained by asking the participants: “Is your walking speed faster than others of the same age and sex?” to which participants responded “yes (faster)” or “no (moderate/slower).” Calcaneal stiffness index was measured.Results; Women with a faster self-reported walking speed were younger and had a lower BMI, higher stiffness index, and higher grip strength than women with a slower walking speed. Multiple linear regression analysis adjusted for age, BMI, grip strength, comorbidity, current smoking, and alcohol drinking status showed a significant association between faster self-reported walking speed and higher calcaneal stiffness index (p < 0.001).Conclusions; Our findings suggest that questionnaires of walking speed may be useful for predicting bone mass and that a fast self-reported walking may benefit bone health in postmenopausal women.

Download Full-text

Differences in sarcopenia prevalence between upper-body and lower-body based EWGSOP2 muscle strength criteria: the Tromsø study 2015–2016

BMC Geriatrics ◽

10.1186/s12877-020-01860-w ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Jonas Johansson ◽

Bjørn Heine Strand ◽

Bente Morseth ◽

Laila Arnesdatter Hopstock ◽

Sameline Grimsgaard

Keyword(s):

Waist Circumference ◽

Grip Strength ◽

Body Height ◽

Community Dwelling ◽

Upper Body ◽

Linear Regression Models ◽

Timed Up And Go ◽

Cross Sectional ◽

Chair Stand ◽

European Working

Abstract Background The European Working Group on Sarcopenia in Older People (EWGSOP2) recommends grip strength and chair stand tests to be used as primary defining measures. It is unclear how either test affects prevalence estimates. Methods This cross-sectional study involved 3498 community-dwelling participants (40–84 years) from the 7th Tromsø Study survey (2015–2016). We used grip strength, five-repetition chair stands, four-meter Walk Speed Test, Timed-Up-and-Go (TUG) and Dual-Energy X-ray Absorptiometry measurements. Data were analyzed using multiple linear regression models and ROC-curves. Results Probable and confirmed sarcopenia prevalence was 1.3 and 4.4% based on grip strength and chair stands, respectively. There was very low agreement between grip strength and chair stand cut-offs (κ = 0.07), with only 4.3% of participants defined as having probable sarcopenia overlapping in the two criteria. Participants with grip strength-based sarcopenia had lower mean height, weight, waist circumference, and appendicular lean mass relative to body height (ALMheight2) than non-sarcopenic participants (all p < 0.001), after adjusting for multiple covariates. Conversely, participants with chair stand-based sarcopenia had similar height, higher weight, waist circumference and body fat% compared to non-sarcopenic participants (all p < 0.05). Area-under-curves (AUCs) for TUG-time were significantly larger when using chair stand instead of grip strength cut-offs (0.86, 95% CI 0.84–0.89 vs. 0.75, 95% CI 0.69–0.83). Conclusions Using chair stands instead of grip strength more than doubled probable sarcopenia prevalence across all ages. The two measures defined individuals of contradictory anthropometrics, body composition, and dissimilar physical function to have probable sarcopenia. Researchers should further evaluate the consequences of using different strength measures in the EWGSOP2 definition to classify sarcopenia.

Download Full-text

A Simple Clinical Scale to Stratify Risk of Recurrent Falls in Community-Dwelling Adults Aged 65 Years and Older

Physical Therapy ◽

10.2522/ptj.20090158 ◽

2010 ◽

Vol 90 (4) ◽

pp. 550-560 ◽

Cited By ~ 80

Author(s):

Severine Buatois ◽

Christine Perret-Guillaume ◽

Rene Gueguen ◽

Patrick Miget ◽

Guy Vançon ◽

...

Keyword(s):

Community Dwelling ◽

Added Value ◽

Clinical Scale ◽

Moderate Risk ◽

Stand Test ◽

Sit To Stand ◽

Balance Tests ◽

Recurrent Falls ◽

Group A ◽

Group B

BackgroundCorrect identification of people at risk for recurrent falls facilitates the establishment of preventive and rehabilitative strategies in older adults.ObjectiveThe purposes of this study were: (1) to develop and validate a simple clinical scale to stratify risk for recurrent falls in community-dwelling elderly people based on easily obtained social and clinical items and (2) to evaluate the added value of 3 clinical balance tests in predicting this risk.DesignThis was a prospective measurement study.MethodsA population of 1,618 community-dwelling people over 65 years of age underwent a health checkup, including performance of 3 clinical balance tests: the One-Leg-Balance Test, the Timed “Up & Go” Test, and the Five-Times-Sit-to-Stand Test. Falls were recorded using a self-administered questionnaire that was completed a mean (SD) of 25±5 months after the visit. Participants were randomly divided into either group A (n=999), which was used to develop the scale, or group B (n=619), which was used to prospectively validate the scale.ResultsLogistic regression analysis identified 4 variables that independently predicted recurrent falls in group A: history of falls, living alone, taking ≥4 medications per day, and female sex. Thereafter, 3 risk categories of recurrent falls (low, moderate, and high) were determined. Predicted probability of recurrent falls increased from 4.1% to 30.1% between the first and third categories. This scale subsequently was validated with great accuracy in group B. Only the Five-Times-Sit-to-Stand Test provided added value in the estimation of risk for recurrent falls, especially for the participants who were at moderate risk, in whom failure on the test (duration of >15 seconds) doubled the risk.LimitationsFalls were assessed only once, and length of follow-up was heterogeneous (18–36 months).ConclusionsClinicians could easily classify older patients in low-, moderate-, or high-risk groups of recurrent falls by using 4 easy-to-obtain items. The Five-Times-Sit-to-Stand Test provides added value to stratify risk for falls in people at moderate risk.

Download Full-text

Toe flexor strength is associated with mobility in older adults with pronated and supinated feet but not with neutral feet

10.21203/rs.3.rs-29886/v2 ◽

2020 ◽

Author(s):

Yuki Kusagawa ◽

Toshiyuki Kurihara ◽

Aiko Imai ◽

Sumiaki Maeo ◽

Takashi Sugiyama ◽

...

Keyword(s):

Older Adults ◽

Young Adults ◽

Older Women ◽

Walking Speed ◽

Community Dwelling ◽

Timed Up And Go ◽

Chair Stand ◽

Foot Posture ◽

Toe Flexor Strength ◽

Flexor Strength

Abstract Background: Older adults are known to have more pronated foot posture and decreased toe flexor strength (TFS), as well as decreased mobility in daily life compared to young adults. Although foot posture is reported to be an influential factor for walking biomechanics in young adults, there is less information on this subject in older adults. Age-related reduction in TFS is shown to be associated with impairments of functional performance, but it is poorly understood whether foot posture influences the relationships between TFS and functional performances. Therefore, the present study aimed to elucidate this concern by examining older women. Methods: Seventy community-dwelling older women (76.8 ± 4.4 years) voluntarily participated in this study. Foot posture was evaluated by the 6-item foot posture index (FPI). Based on the FPI score, participants were allocated to pronated, neutral, or supinated group (n = 33, 26, and 11, respectively). TFS was assessed using a toe grip dynamometer in a seated position. Scores of 30-second chair stand, timed up-and-go, 5-m comfortable-speed walking, and static balance tests were determined to evaluate functional performances. Pearson’s correlation coefficients were computed to examine the relationships between TFS and functional performances in each group. Results: TFS positively correlated with comfortable walking speed in the pronated (r = 0.37, p = 0.03) and supinated (r = 0.76, p < 0.001) groups, but not in the neutral group (r = 0.17, p = 0.42). For the two significant relationships, an analysis of covariance showed that there was no significant difference between the pronated and supinated groups in the slopes of the regression lines, suggesting a similar relative contribution of TFS to comfortable walking speed between the two groups. In addition, TFS tended to negatively correlate with timed up-and-go time in the pronated (r = -0.32, p = 0.07) and supinated (r = -0.56, p = 0.08) groups, and positively correlate with 30-second chair stand score in the pronated group (r = 0.31, p = 0.08). Conclusions: The present study indicates that TFS would be associated with mobility, walking performance in particular, in older women with pronated and supinated feet but not with neutral feet.

Download Full-text

Association between self-reported walking speed and calcaneal stiffness index in postmenopausal Japanese women

10.21203/rs.3.rs-22356/v2 ◽

2020 ◽

Author(s):

Yoshihito Tomita ◽

Kazuhiko Arima ◽

Satoshi Mizukami ◽

Ritsu Tsujimoto ◽

Shin-ya Kawashiri ◽

...

Keyword(s):

Bone Mass ◽

Grip Strength ◽

Postmenopausal Women ◽

Walking Speed ◽

Linear Regression Analysis ◽

Japanese Women ◽

Community Dwelling ◽

Stiffness Index ◽

Public Health Issue ◽

Increased Risk

Abstract Background; Osteoporosis and related fractures, a worldwide public health issue of growing concern, is characterized by compromised bone strength and an increased risk of fracture. Here we show an association between self-reported walking speed and bone mass among community-dwelling postmenopausal Japanese women aged 50 years and older. Design; Cross-sectional study.Setting and Participants; The survey population included 1008 postmenopausal women 50–92 years of age residing in rural communities.Methods; Self-reported walking speed was ascertained by asking the participants: “Is your walking speed faster than others of the same age and sex?” to which participants responded “yes (faster)” or “no (moderate/slower).” Calcaneal stiffness index was measured.Results; Women with a faster self-reported walking speed were younger and had a lower BMI, higher stiffness index, and higher grip strength than women with a slower walking speed. Multiple linear regression analysis adjusted for age, BMI, grip strength, comorbidity, current smoking, and alcohol drinking status showed a significant association between faster self-reported walking speed and higher calcaneal stiffness index (p < 0.001).Conclusions; Our findings suggest that questionnaires of walking speed may be useful for predicting bone mass and that a fast self-reported walking may benefit bone health in postmenopausal women.

Download Full-text

Reliability, measurement error and minimum detectable change in mobility measures: a cohort study of community-dwelling adults aged 50 years and over in Ireland

BMJ Open ◽

10.1136/bmjopen-2019-030475 ◽

2019 ◽

Vol 9 (11) ◽

pp. e030475 ◽

Cited By ~ 3

Author(s):

Orna A Donoghue ◽

George M Savva ◽

Axel Börsch-Supan ◽

Rose Anne Kenny

Keyword(s):

Gait Speed ◽

Walking Speed ◽

Intraclass Correlation ◽

Health Assessment ◽

Population Based ◽

Time Of Day ◽

Community Dwelling ◽

Detectable Change ◽

Timed Up And Go ◽

Minimum Detectable Change

ObjectiveTo estimate the effects of repeat assessments, rater and time of day on mobility measures and to estimate their variation between and within participants in a population-based sample of Irish adults aged ≥50 years.DesignTest–retest study in a population representative sample.SettingAcademic health assessment centre of The Irish Longitudinal Study on Ageing (TILDA).Participants128 community-dwelling adults from the Survey for Health, Ageing and Retirement in Europe (SHARE) Ireland study who agreed to take part in the SHARE-Ireland/TILDA collaboration.InterventionsNot applicable.Outcome measuresParticipants performed timed up-and-go (TUG), repeated chair stands (RCS) and walking speed tests administered by one of two raters. Repeat assessments were conducted 1–4 months later. Participants were randomised with respect to a change in time (morning, afternoon) and whether the rater was changed between assessments. Within and between-participant variance for each measure was estimated using mixed-effects models. Intraclass correlation (ICC), SE of measurement and minimum detectable change (MDC) were reported.ResultsAverage performance did not vary between baseline and repeat assessments in any test, except RCS. The rater significantly affected performance on all tests except one, but time of day did not. Reliability varied from ICC=0.66 (RCS) to ICC=0.88 (usual gait speed). MDC was 2.08 s for TUG, 4.52 s for RCS and ranged from 19.49 to 34.73 cm/s for walking speed tests. There was no evidence for lower reliability of gait parameters with increasing time between assessments.ConclusionsReliability varied for each test when measurements are obtained over 1–4 months with most variation due to rater effects. Usual and motor dual task gait speed demonstrated highest reliability.

Download Full-text

Reliability and Validity of the Ground Reaction Force Asymmetric Index at Seat-Off as a Measure of Lower Limb Functional Muscle Strength: A Preliminary Study

Applied Sciences ◽

10.3390/app11146527 ◽

2021 ◽

Vol 11 (14) ◽

pp. 6527

Author(s):

Ae-Ryoung Kim ◽

Dougho Park ◽

Yang-Soo Lee

Keyword(s):

Muscle Strength ◽

Grip Strength ◽

Ground Reaction Force ◽

Walking Speed ◽

Reaction Force ◽

Hand Grip Strength ◽

Community Dwelling ◽

Intrarater Reliability ◽

Hand Grip ◽

The Right

This study examined the reliability of the newly developed ground reaction force asymmetry index (GRF AI) at seat-off using a low-cost force plate and the validity of this new test by comparing it with other muscle strength-measuring methods and walking speed. This study was a cross-sectional design in general hospital setting. A convenience sample of 47 community-dwelling adults aged ≥40 years was performed. GRF AI is the measurement value obtained by shifting the weight to the right and left while performing sit-to-stand (STS). GRF AI assessed using GRF data at seat-off during an STS test with maximal weight shift to the right and left side and repeated 4 weeks later. Hip and knee extensor strength were measured using hand-held dynamometry; hand grip strength and walking speed were measured using a standardized method. Intrasessional intrarater reliability of the right and left side at Sessions 1 and 2 were high (intraclass correlation coefficients [ICC] = 0.947 and 0.974; 0.931 and 0.970, respectively). In addition, the intersessional intrarater reliability of a single test trial (ICC = 0.911 and 0.930) and the mean of three test trials (ICC = 0.965 and 0.979) was also high. There was a low correlation between right-side GRF AI and right hand grip strength (r = 0.268) and between left-side GRF AI and left hand grip strength (r = 0.316). No significant correlations were found between the GRF AI and other parameters. Although the reliability of the GRF AI was high, the validity was poor. To be clinically useful, this test should be further refined by modifying the test protocol.

Download Full-text

Abstract 12981: Association of Serum Growth Differentiation Factor-15 With Egfr, Hemoglobin and Sarcopenia in Healthy Community-dwelling Older Females

Circulation ◽

10.1161/circ.142.suppl_3.12981 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Taira Fukuda ◽

Shigeru Toyoda ◽

Shichiro Abe ◽

Teruo Inoue ◽

Toshiaki Nakajima

Keyword(s):

Renal Dysfunction ◽

Grip Strength ◽

Walking Speed ◽

Bioelectrical Impedance ◽

Hand Grip Strength ◽

Community Dwelling ◽

Enzyme Linked Immunosorbent Assay ◽

Older Individuals ◽

Hand Grip ◽

Healthy Community

Introduction: Anemia and sarcopenia with renal dysfunction caused by cytokine imbalance can contribute to decreased quality of life for older individuals. Several studies showed that serum GDF-15 level, a member of the TGF-β cytokine superfamily, was negatively correlated with eGFR. In this study, we examined the association of GDF-15 with eGFR, hemoglobin (Hb) and sarcopenia in healthy community-dwelling older females. Methods: A total of 66 healthy older community-dwelling females (age: 75.8 ± 6.2 years) were enrolled for this study. Skeletal muscle mass index (SMI) by bioelectrical impedance analysis, hand-grip strength and walking speed were assessed, and sarcopenia was evaluated. Serum GDF-15 concentration was determined by enzyme-linked immunosorbent assay. Hb, serum iron (Fe), serum albumin (Alb) and high-sensitive C reactive protein (hsCRP) levels were measured and estimated glomerular filtration rate (eGFR) was evaluated. Multiple linear regression analyses with serum GDF-15 concentration, eGFR and Hb as the dependent variable were performed to identify influencing independent factors. Results: Among the study subjects, 4 (6%) had sarcopenia. The serum GDF-15 level was positively correlated with age (r = 0.486, p < 0.001) and negatively correlated with walking speed (r = -0.363, p = 0.003), but there was no correlation between GDF-15 level and hand-grip strength or SMI. Serum GDF-15 level was also negatively correlated with eGFR (r = -0.535, p < 0.001) and serum Fe level, but had no correlation with hsCRP, Hb or Alb levels. In multiple regression analysis, eGFR and Hb were independent variables to predict serum GDF-15 level, even after adjusting for age and body mass index (eGFR: β = -0.423, p <0.001; Hb: β = -0.363, p=0.004). Serum GDF-15 level was an independent variable to predict eGFR and Hb. Conclusions: Serum GDF-15 level was negatively correlated with eGFR, although it had no correlation with muscle strength or mass. Both Hb and eGFR were predictors for serum GDF-15 concentration in healthy older females. In these community-dwelling older females, renal dysfunction via GDF-15 might be accompanied by anemia, but not sarcopenia.

Download Full-text

Application of SDOC Cut Points for Low Muscle Strength for Recovery of Walking Speed After Hip Fracture

The Journals of Gerontology Series A ◽

10.1093/gerona/glaa076 ◽

2020 ◽

Vol 75 (7) ◽

pp. 1379-1385 ◽

Cited By ~ 2

Author(s):

Denise L Orwig ◽

Jay Magaziner ◽

Roger A Fielding ◽

Hao Zhu ◽

Ellen F Binder ◽

...

Keyword(s):

Hip Fracture ◽

Muscle Strength ◽

Grip Strength ◽

Walking Speed ◽

High Sensitivity ◽

Community Dwelling ◽

Meaningful Change ◽

Cut Points ◽

Speed Performance ◽

Total Body

Abstract Background Sarcopenia is often conceptualized as a precursor to loss of mobility, but its effect on recovery of mobility after a hip fracture is unknown. We determined the prevalence of low muscle strength (weakness) after hip fracture using putative sarcopenia metrics (absolute grip strength, and grip strength normalized to body mass index, total body fat, arm lean mass, and weight) identified by the Sarcopenia Definitions and Outcomes Consortium (SDOC). Methods We examined two well-characterized hip fracture cohorts of community-dwelling older adults from the Baltimore Hip Studies (BHS). The prevalence of muscle weakness was assessed using the SDOC cut points compared to published definitions at 2 and 6 months postfracture. We assessed associations of 2-month weakness with 6-month walking speed <0.6 m/s and calculated the sensitivity and specificity in predicting lack of meaningful change in walking speed (change < 0.1 m/s) at 6 months. Results Two hundred and forty-six participants (192 women; 54 men) were included; mean (SD) age of 81 (8) for women and 78 (7) for men. At 2 months, 91% women and 78% men exhibited slow walking speed (< 0.6 m/s). SDOC grip strength standardized by weight (<0.34 kg women, <0.45 kg men) was the most prevalent measure of weakness in men (74%) and women (79%) and provided high sensitivity in men (86%) and women (84%) predicting lack of meaningful change in walking speed at 6 months, although specificity was poor to moderate. Conclusions SDOC cut points for grip strength standardized to weight provided consistent indication of poor walking speed performance post-hip fracture.

Download Full-text

Toe flexor strength is associated with mobility in older adults with pronated and supinated feet but not with neutral feet

Journal of Foot and Ankle Research ◽

10.1186/s13047-020-00422-y ◽

2020 ◽

Vol 13 (1) ◽

Author(s):

Yuki Kusagawa ◽

Toshiyuki Kurihara ◽

Aiko Imai ◽

Sumiaki Maeo ◽

Takashi Sugiyama ◽

...

Keyword(s):

Older Adults ◽

Young Adults ◽

Older Women ◽

Walking Speed ◽

Community Dwelling ◽

Timed Up And Go ◽

Chair Stand ◽

Foot Posture ◽

Toe Flexor Strength ◽

Flexor Strength

Abstract Background Older adults are known to have more pronated foot posture and decreased toe flexor strength (TFS), as well as decreased mobility in daily life compared to young adults. Although foot posture is reported to be an influential factor for walking biomechanics in young adults, there is less information on this subject in older adults. Age-related reduction in TFS is shown to be associated with impairments of functional performance, but it is poorly understood whether foot posture influences the relationships between TFS and functional performances. Therefore, the present study aimed to elucidate this concern by examining older women. Methods Seventy community-dwelling older women (76.8 ± 4.4 years) voluntarily participated in this study. Foot posture was evaluated by the 6-item foot posture index (FPI). Based on the FPI score, participants were allocated to pronated, neutral, or supinated group (n = 33, 26, and 11, respectively). TFS was assessed using a toe grip dynamometer in a seated position. Scores of 30-s chair stand, timed up-and-go, 5-m comfortable-speed walking, and static balance tests were determined to evaluate functional performances. Pearson’s correlation coefficients were computed to examine the relationships between TFS and functional performances in each group. Results TFS positively correlated with comfortable walking speed in the pronated (r = 0.37, p = 0.03) and supinated (r = 0.76, p < 0.001) groups, but not in the neutral group (r = 0.17, p = 0.42). For the two significant relationships, an analysis of covariance showed that there was no significant difference between the pronated and supinated groups in the slopes of the regression lines, suggesting a similar relative contribution of TFS to comfortable walking speed between the two groups. In addition, TFS tended to negatively correlate with timed up-and-go time in the pronated (r = − 0.32, p = 0.07) and supinated (r = − 0.56, p = 0.08) groups, and positively correlate with 30-s chair stand score in the pronated group (r = 0.31, p = 0.08). Conclusions The present study indicates that TFS would be associated with mobility, walking performance in particular, in older women with pronated and supinated feet but not with neutral feet.

Download Full-text