Does Hemodialysis Affect Upper Extremity Functional Capacity, Physical Activity and Physical Function of Patients?

Background and objective: Managing the decrease in physical function in the elderly is a major task in aging societies globally. Here, we aimed to compare the physical function and metabolic syndrome (MetS) risk factors according to levels of physical activity (PA). Material and methods: We measured PA in 77 elderly Korean men (74.21 ± 6.26 years old) with an accelerometer and recorded body composition, physical function, and MetS-related risk factors. Participants were divided into three groups based on daily moderate-vigorous physical activity (MVPA): low (under 60 min), middle (60-120 min), and high (over 120 min). The groups were compared using a one-way analysis of variance and the Scheffe post hoc test. Odds ratios (OR) were calculated by logistic regression analysis. Results: Signiﬁcant differences were found between the groups for sedentary behavior time (P < 0.001), light PA (P < 0.05), moderate PA (P < 0.001), vigorous PA (P < 0.05), and total energy expenditure (P < 0.001). The high PA group showed a signiﬁcantly lower percentage of body fat and fat mass and higher muscle mass than did the low and middle PA groups (P < 0.05). The 6-min walk test was signiﬁcantly better in the high PA group than in the low and middle PA groups (P < 0.05). Grip strength and the Berg balance scale were also signiﬁcantly better in the high PA group (P < 0.05). Bone mineral density (BMD) and high-density lipoprotein cholesterol (HDL-C) were signiﬁcantly higher in the high PA group than in the low PA group (P < 0.05). Systolic blood pressure (SBP) was signiﬁcantly higher in the middle PA group than in the low PA group (P < 0.05). Participants with more than three MetS criteria showed an OR of 0.09 (95% conﬁdence interval 0.01-0.82) in the high PA group as compared with the low PA group (P < 0.05). Conclusions: Moderate-vigorous physical activity of more than 120 min daily showed better physical function and lower OR of MetS than did lower MVPA levels in elderly Korean men.

Download Full-text

Considerations for assessing physical function and physical activity in clinical trials during the COVID-19 pandemic

Contemporary Clinical Trials ◽

10.1016/j.cct.2021.106407 ◽

2021 ◽

Vol 105 ◽

pp. 106407

Author(s):

Seol Ju E. Moon ◽

Annette DeVito Dabbs ◽

Andrea L. Hergenroeder ◽

Melissa L. Vendetti ◽

Kristen B. Jones ◽

...

Keyword(s):

Physical Activity ◽

Clinical Trials ◽

Physical Function

Download Full-text

Women’s Health Initiative Strong and Healthy Pragmatic Physical Activity Intervention Trial for Cardiovascular Disease Prevention: Design and Baseline Characteristics

The Journals of Gerontology Series A ◽

10.1093/gerona/glaa325 ◽

2021 ◽

Author(s):

Marcia L Stefanick ◽

Abby C King ◽

Sally Mackey ◽

Lesley F Tinker ◽

Mark A Hlatky ◽

...

Keyword(s):

Physical Activity ◽

Cardiovascular Disease ◽

Physical Function ◽

Women’S Health ◽

Women's Health ◽

Physical Activity Intervention ◽

Women's Health Initiative ◽

Women’S Health Initiative ◽

Health Initiative ◽

Race Ethnicity

Abstract Background National guidelines promote physical activity to prevent cardiovascular disease (CVD), yet no randomized controlled trial has tested whether physical activity reduces CVD. Methods The Women’s Health Initiative (WHI) Strong and Healthy (WHISH) pragmatic trial used a randomized consent design to assign women for whom cardiovascular outcomes were available through WHI data collection (N = 18 985) or linkage to the Centers for Medicare and Medicaid Services (N30 346), to a physical activity intervention or “usual activity” comparison, stratified by ages 68–99 years (in tertiles), U.S. geographic region, and outcomes data source. Women assigned to the intervention could “opt out” after receiving initial physical activity materials. Intervention materials applied evidence-based behavioral science principles to promote current national recommendations for older Americans. The intervention was adapted to participant input regarding preferences, resources, barriers, and motivational drivers and was targeted for 3 categories of women at lower, middle, or higher levels of self-reported physical functioning and physical activity. Physical activity was assessed in both arms through annual questionnaires. The primary outcome is major cardiovascular events, specifically myocardial infarction, stroke, or CVD death; primary safety outcomes are hip fracture and non-CVD death. The trial is monitored annually by an independent Data Safety and Monitoring Board. Final analyses will be based on intention to treat in all randomized participants, regardless of intervention engagement. Results The 49 331 randomized participants had a mean baseline age of 79.7 years; 84.3% were White, 9.2% Black, 3.3% Hispanic, 1.9% Asian/Pacific Islander, 0.3% Native American, and 1% were of unknown race/ethnicity. The mean baseline RAND-36 physical function score was 71.6 (± 25.2 SD). There were no differences between Intervention (N = 24 657) and Control (N = 24 674) at baseline for age, race/ethnicity, current smoking (2.5%), use of blood pressure or lipid-lowering medications, body mass index, physical function, physical activity, or prior CVD (10.1%). Conclusion The WHISH trial is rigorously testing whether a physical activity intervention reduces major CV events in a large, diverse cohort of older women. Clinical Trials Registration Number: NCT02425345

Download Full-text

Novel Analytic Approaches to Investigate Minute-Level Actigraphy and Associations With Physical Function

Innovation in Aging ◽

10.1093/geroni/igaa057.630 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 194-195

Author(s):

Kaiyuan Hua ◽

Sheng Luo ◽

Katherine Hall ◽

Miriam Morey ◽

Harvey Cohen

Keyword(s):

Physical Activity ◽

Data Analysis ◽

Physical Function ◽

Functional Data Analysis ◽

Functional Data ◽

Gait Speed ◽

Community Dwelling ◽

Accelerometer Data ◽

Single Leg Stance ◽

Minute Walk

Abstract Background. Functional decline in conjunction with low levels of physical activity has implications for health risks in older adults. Previous studies have examined the associations between accelerometry-derived activity and physical function, but most of these studies reduced these data into average means of total daily physical activity (e.g., daily step counts). A new method of analysis “functional data analysis” provides more in-depth capability using minute-level accelerometer data. Methods. A secondary analysis of community-dwelling adults ages 30 to 90+ residing in southwest region of North Carolina from the Physical Performance across the Lifespan (PALS) study. PALS assessments were completed in-person at baseline and one-week of accelerometry. Final analysis includes 669 observations at baseline with minute-level accelerometer data from 7:00 to 23:00, after removing non-wear time. A novel scalar-on-function regression analysis was used to explore the associations between baseline physical activity features (minute-by-minute vector magnitude generated from accelerometer) and baseline physical function (gait speed, single leg stance, chair stands, and 6-minute walk test) with control for baseline age, sex, race and body mass index. Results. The functional regressions were significant for specific times of day indicating increased physical activity associated with increased physical function around 8:00, 9:30 and 15:30-17:00 for rapid gait speed; 9:00-10:30 and 15:00-16:30 for normal gait speed; 9:00-10:30 for single leg stance; 9:30-11:30 and 15:00-18:00 for chair stands; 9:00-11:30 and 15:00-18:30 for 6-minute walk. Conclusion. This method of functional data analysis provides news insights into the relationship between minute-by-minute daily activity and health.

Download Full-text

Physical Activity and Sport for Acquired Brain Injury (PASABI): A Non-Randomized Controlled Trial

Medicina ◽

10.3390/medicina57020122 ◽

2021 ◽

Vol 57 (2) ◽

pp. 122

Author(s):

Marta Pérez-Rodríguez ◽

Saleky García-Gómez ◽

Javier Coterón ◽

Juan José García-Hernández ◽

Javier Pérez-Tejero

Keyword(s):

Quality Of Life ◽

Physical Activity ◽

Brain Injury ◽

Functional Capacity ◽

Intervention Group ◽

Chronic Phase ◽

Acquired Brain Injury ◽

Control Group ◽

Wide Range

Background and objectives: Acquired brain injury (ABI) is the first cause of disability and physical activity (PA) is a key element in functional recovery and health-related quality of life (HRQoL) during the subacute and chronic phases. However, it is necessary to develop PA programs that respond to the heterogeneity and needs of this population. The aim of this study was to assess the effectiveness of a PA program on the HRQoL in this population. Materials and Methods: With regard to recruitment, after baseline evaluations, participants were assigned to either the intervention group (IG, n = 38) or the control group (CG, n = 35). Functional capacity, mood, quality of life and depression were measured pre- and post-intervention. The IG underwent the “Physical Activity and Sport for Acquired Brain Injury” (PASABI) program, which was designed to improve HRQoL (1-h sessions, two to four sessions/week for 18 weeks). The CG underwent a standard rehabilitation program without PA. Results: Results for the IG indicated significant differences and large effect sizes for the physical and mental dimensions of quality of life, as well as mood and functional capacity, indicating an increase in HRQoL. No significant differences were found for the CG across any variables. Conclusions: The PASABI program was feasible and beneficial for improving physiological and functionality variables in the IG. The wide range of the activities of the PASABI program allow its application to a large number of people with ABI, promoting health through PA, especially in the chronic phase.

Download Full-text

EXPRESS: Association of daily physical activity with psychosocial aspects and functional capacity in patients with Pulmonary Arterial Hypertension: a cross-sectional study

Pulmonary Circulation ◽

10.1177/2045894021999955 ◽

2021 ◽

pp. 204589402199995

Author(s):

Layse Nakazato Lima ◽

Felipe Mendes ◽

Ilma Paschoal ◽

Daniela Oliveira ◽

Marcos Mello Moreira ◽

...

Keyword(s):

Quality Of Life ◽

Physical Activity ◽

Pulmonary Arterial Hypertension ◽

Arterial Hypertension ◽

Functional Capacity ◽

Daily Physical Activity ◽

Cross Sectional ◽

Pulmonary Arterial ◽

The Mean

Pulmonary arterial hypertension (PAH) impairs exercise tolerance and daily physical activity (PA). Aside from the hemodynamic limitations, physical, cognitive and emotional factors may play a relevant and as yet unexplored role. We investigated whether there is an association between the PA level and psychological disorders, health-related quality of life, and daily activities. We also searched for an association of the PA level with clinical factors and functional capacity. This was an analytical, cross-sectional, observational study conducted in a Brazilian University Hospital. Twenty stable PAH subjects wore an accelerometer for a week and completed an activity diary. They answered the quality of life questionnaire (SF-36), as well as the anxiety and depression scale (HADS), and the Manchester Respiratory Activities of Daily Living questionnaire (MRADL). Transthoracic echocardiography, the 6-Minute walk test (6MWT), the 1-minute sit-to-stand test (STST), and spirometry were performed. For statistical analysis we used Chi-square tests or Fisher's test as appropriate and the Mann-Whitney test to compare numerical values between two groups. The relationship between the parameters was assessed using the Spearman correlation test. The mean age was 44.3 years, 80% were women, 80% had idiopathic PAH, and 20% had connective tissue disease . The mean daily step count was 4,280 Â± 2,351, and the mean activity time was 41.6 Â± 19.3 minutes. The distance covered (6MWT) was 451.5 m, and the number of movements (1-STST) was 23.8. Thirty percent scored positive for anxiety, and 15% for depression (HADS). There was a significant correlation between accelerometer data and walking distance (6MWT), number of movements (1-STST), level of daily physical activity (MRADL), and depression symptoms. Our findings support the hypothesis that other aspects beyond physical and hemodynamic ones might impact the daily physical activity of patients with PAH.

Download Full-text

A Physical Activity Intervention Feasibility Study for Kidney Inpatients: A Basic Research Protocol

Canadian Journal of Kidney Health and Disease ◽

10.1177/2054358120987052 ◽

2021 ◽

Vol 8 ◽

pp. 205435812098705

Author(s):

Kathryn Wytsma-Fisher ◽

Stefan Mustata ◽

Theresa Cowan ◽

Manuel Ester ◽

S. Nicole Culos-Reed

Keyword(s):

Quality Of Life ◽

Physical Activity ◽

Physical Function ◽

Kidney Failure ◽

Standard Care ◽

Physical Activity Intervention ◽

Clinical Care ◽

Activity Promotion ◽

Cardiovascular Morbidity And Mortality

Background: Low physical activity levels and poor physical functioning are strongly associated with poor clinical outcomes and mortality in adult kidney failure patients, regardless of treatment modality. Compared with the general population, individuals with chronic kidney disease are physically inactive, have reduced physical abilities and difficulties performing routine daily tasks, lower health-related quality of life, and higher cardiovascular morbidity and mortality. In addition, frail kidney failure patients have higher hospitalization and mortality rates as compared with other kidney failure patients. Evidence suggests that assessment and recommendations for physical activity should be part of standard care for kidney failure patients. Structured exercise can improve physical function and quality of life in frail older adults and may be used specifically for management of frailty in kidney failure. However, research is needed to determine best practices for implementation of physical function measurements and physical activity promotion in standard kidney failure care. Objective: The proposed Move More study will assess the feasibility of a physical activity intervention offered to the kidney failure inpatients in Calgary, Alberta. Specifically, this study is designed to examine the effects of an early physical activity/mobility intervention led by a kinesiologist, and supported by the clinical care team including physiotherapists (PT) and nurse clinicians. Methods: The Move More study is a single-arm pilot intervention examining feasibility and optimal improvement in real-world conditions. Kidney failure inpatients at the Foothills Medical Centre will be recruited to participate. Patients will receive an individualized in-hospital physical activity/mobility intervention. Frailty and physical function will be assessed at baseline and postintervention prior to hospital discharge. The goal is to recruit 24 to 36 patients. Conclusions: Evidence needed to support the inclusion of mobility and physical activity as part of standard care will be gathered, with knowledge gained used to help direct future physical activity programming for kidney failure inpatients.

Download Full-text