scholarly journals Lower Limb Strength Profile in Elderly with Different Pathologies: Comparisons with Healthy Subjects

Geriatrics ◽  
2020 ◽  
Vol 5 (4) ◽  
pp. 83
Author(s):  
Valentina Bullo ◽  
Enrico Roma ◽  
Stefano Gobbo ◽  
Federica Duregon ◽  
Manuele Bergamo ◽  
...  

Sarcopenia and muscle strength reduction are a frequent disorder in non-communicable chronic diseases. The aims of this study are: (a) to verify if the absolute and relative to body weight muscle strength of lower limb is affected by the presence of pathology; (b) to verify if the trends are different among knee and ankles joints. One-hundred and forty-five elderly were recruited (16 liver transplant recipients, 48 kidney transplant recipients, 52 elderly with obesity, 30 healthy elderly). Muscular strength of lower limb was evaluated. Evaluation protocol included maximal isometric knee extension, maximal isokinetic knee extension and flexion, maximal isokinetic ankle (both right and left) extension and flexion. A statistically significant interaction between measurement and group membership was found for absolute strength measure (F (4.23, 170.56) = 3.316, p = 0.011, partial η2 (η2p) = 0.076), and relative strength measure(F (4.44, 174.72) = 16.407, p < 0.01, partial η2 (η2p) = 0.294). Elderly patients living with kidney transplants showed the lower level of absolute muscular strength, while relative muscular strength is mainly lacking in the elderly with obesity. The strength profile of elderly subjects is affected by obesity, liver transplantation, and kidney transplantation.

Author(s):  
Marieli Ramos Stocco ◽  
Deise Aparecida de Almeida Pires-Oliveira ◽  
Laís Campus de Oliveira ◽  
Raphael Gonçalves de Oliveira ◽  
Fábio Antônio Néia Martini ◽  
...  

Introduction: Declines of static postural balance and muscle strength, especially of lower limbs are strong predictors of falls in the elderly. Objective: The objective of this study was to identify the possible correlation between static postural balance, falls and isokinetic torque peak of knee extensors and flexors in the elderly. Methods: A cross-sectional study with anthropometric evaluation of static postural balance in unipodal limb support was performed using the force platform, flexural strength test and knee extension of the dominant limb using the isokinetic dynamometer and the application of a structured questionnaire on falls. They agreed to participate in the study 106 volunteers of both sexes through the signing of the free and informed consent. The data were treated in the Statistical Package for the Social Sciences program version 20.0. Results: There was a weak positive correlation between center of pressure (COP) area and peak flexion torque (r=0.204, p=0.041) and extension (r=0.228; p=0.022) of the knee, as well as peak extension (r=0.319, p=0.001) and lateral mean (r=0.324, p=0.001). A moderate positive correlation between COP area and anteroposterior velocity (r=0.694, p=0.000) and lateral mean (r = 0.646; p = 0.000) and strong positive correlation was found only between peak flexion torque and knee extension (r=0.719, p=0.000). Conclusion: There was a weak correlation between static postural balance and dominant lower limb muscle strength, and there was no correlation between falls and lower limb muscle strength, or between falls and static postural balance in the studied sample.


2010 ◽  
Vol 130 (2) ◽  
pp. 267-274 ◽  
Author(s):  
Kazuhiko Yamashita ◽  
Kazuya Imaizumi ◽  
Yumi Iwakami ◽  
Mitsuru Sato ◽  
Sawako Nakajima ◽  
...  

1999 ◽  
Vol 9 (3) ◽  
pp. 197-205
Author(s):  
L.L. Borger ◽  
S.L. Whitney ◽  
M.S. Redfern ◽  
J.M. Furman

Postural sway during stance has been found to be sensitive to moving visual scenes in young adults, children, and those with vestibular disease. The effect of visual environments on balance in elderly individuals is relatively unknown. The purpose of this study was to compare postural sway responses of healthy elderly to those of young subjects when both groups were exposed to a moving visual scene. Peak to peak, root mean squared, and mean velocity of the center of pressure were analyzed under conditions combining four moving scene amplitudes ( 2 . 5 ∘ , 5 ∘ , 7 . 5 ∘ , 10 ∘ ) and two frequencies of scene movement (0.1 Hz, 0.25 Hz). Each visual condition was tested with a fixed floor and sway referenced platform. Results showed that elderly subjects swayed more than younger subjects when experiencing a moving visual scene under all conditions. The elderly were affected more than the young by sway referencing the platform. The differences between the two age groups were greater at increased amplitudes of scene movement. These results suggest that elderly are more influenced by dynamic visual information for balance than the young, particularly when cues from the ankles are altered.


2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Alexandre Candellier ◽  
Eric Jean Goffin ◽  
Priya Vart ◽  
Marlies Noordzij ◽  
Miha Arnol ◽  
...  

Abstract Background and Aims Studies examining kidney failure patients with COVID-19 reported higher mortality in hemodialysis patients than in kidney transplant recipients. However, hemodialysis patients are often older and have more comorbidities. This study investigated the association of type of kidney replacement therapy with COVID-19 severity adjusting for differences in characteristics. Method Data were retrieved from the European Renal Association COVID-19 Database (ERACODA), which includes kidney replacement therapy patients diagnosed with COVID-19 from all over Europe. We included all kidney transplant recipients and hemodialysis patients who presented between February 1st and December 1st 2020 and had complete information reason for COVID-19 screening and vital status at day 28. The diagnosis of COVID-19 was made based on a PCR of a nasal or pharyngeal swab specimens and/or COVID-19 compatible findings on a lung CT scan. The association of kidney transplantation or hemodialysis with 28-day mortality was examined using Cox proportional-hazards regression models adjusted for age, sex, frailty and comorbidities. Additionally, this association was investigated in the subsets of patients that were screened because of symptoms or have had routine screening. Results A total of 1,670 patients (496 functional kidney transplant recipients and 1,174 hemodialysis patients) were examined. 16.9% of kidney transplant recipients and 23.9% of hemodialysis patients died within 28 days of presentation. In an unadjusted model, the risk of 28-day mortality was 33% lower in kidney transplant recipients compared with hemodialysis patients (hazard ratio (HR): 0.67, 95% CI: 0.52, 0.85). However, in an age, sex and frailty adjusted model, the risk of 28-day mortality was 29% higher in kidney transplant recipients (HR=1.29, 95% CI: 1.00, 1.68), whereas in a fully adjusted model the risk was even 43% higher (HR=1.43, 95% CI: 1.06, 1.93). This association in patients who were screened because of symptoms (n=1,145) was similar (fully adjusted model HR=1.46, 95% CI: 1.05, 2.04). Results were similar when other endpoints were studied (e.g. risk for hospitalization, ICU admission or mortality beyond 28 days) as well as across subgroups. Only age was found to interact significantly, suggesting that the increased mortality risk associated with kidney transplantation was especially present in elderly subjects. Conclusion In this study, kidney transplant recipients had a greater risk of a more severe course of COVID-19 compared with hemodialysis patients when adjusted for age, sex and comorbidities.


2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Dario Gregori ◽  
Honoria Ocagli ◽  
Corrado Lanera ◽  
Giulia Lorenzoni

Abstract Objectives Elderly patients are at risk of malnutrition and need an appropriate assessment of energy requirements. In the clinical setting, predictive equations are widely used to estimate the Resting Energy Expenditure (REE). Although easy to use, these equations are not always validated for the elderly and, even if validated, they often provide different outputs of energy requirements for the same subject. This study aimed at doing a systematic review of the equations for the estimation of REE in the elderly with the final aim of developing a web-based application helping clinicians in finding out the most appropriate equation for estimating the REE for each subject. Methods The systematic review was carried out using PubMed and Scopus following PRISMA guidelines. Studies in subjects older than 65 years of age, testing the performance of a predictive equation for the estimation of REE vs. a gold standard (indirect calorimetry or doubly labeled water) were included in the review. Studies performed in critically ill elderly patients were excluded. Results The initial search identified 2035 studies. The final review included 50 studies. Included studies were mainly observational, conducted in healthy elderly subjects enrolled in the outpatient setting, and using indirect calorimetry as gold standard. The 50 studies included in the review corresponded to 189 different equations. Several parameters were included in the equations and they can be divided as following: anthropometric characteristics, body composition parameters, environmental measures, laboratory tests, presence of comorbidities, and physical activity frequency. Conclusions The assessment of the energy requirements in the elderly is crucial for the management of nutritional problems in this population group since nutritional problems are related to worse health outcomes. The present study showed a wide use of different type of equations for the estimation of REE in the elderly highlighting the need of choosing the most appropriate predictive equation according to the subject characteristics and health status. The web application that is currently under development will help clinicians in doing that. Funding Sources Unit of Biostatistics, Epidemiology and Public Health, University of Padova, Padova, Italy.


2020 ◽  
Vol 6 ◽  
pp. 233372142097980
Author(s):  
Kenichi Kaneko ◽  
Hitoshi Makabe ◽  
Kazuyuki Mito ◽  
Kazuyoshi Sakamoto ◽  
Yoshiya Kawanori ◽  
...  

This study examined the characteristics of lower limb muscle activity in elderly persons after ergometric pedaling exercise for 1 month. To determine the effect of the exercise, surface electromyography (SEMG) of lower limb muscles was subjected to Daubechies-4 wavelet transformation, and mean wavelet coefficients were compared with the pre-exercise coefficients and the post-exercise coefficients in each wavelet level. The characteristics of muscle activity after pedaling exercise were also compared between the elderly subjects and young subjects. For the elderly subjects, the mean wavelet coefficients were significantly decreased in the tibialis anterior and the gastrocnemius medialis at wavelet levels of 3, 4, and 5 (125–62.5, 62.5–31.25, and 31.25–15.625 Hz, respectively), by pedaling exercise. However, the mean power of wavelet levels of 2 and 3 (250–125 and 125–62.5 Hz) within the rectus femoris and the biceps femoris were significantly increased in the young subjects. The effect of pedaling exercise is different from the effects of heavy-resistance training. It was suggested that the muscle coordination, motor unit (MU) firing frequency, and firing fiber type of lower limb muscles are changed with the different characteristics between elderly and young persons by pedaling exercise for 1 month.


1994 ◽  
Vol 87 (3) ◽  
pp. 297-302 ◽  
Author(s):  
G. A. Ford ◽  
O. F. W. James

1. Cardiac chronotropic responses to isoprenaline are reduced with ageing in man. It is unclear whether this is due to reduced cardiac β-adrenergic sensitivity or to age-associated differences in reflex cardiovascular responses to the vasodilatory effects of isoprenaline. Age-associated changes in physical activity are also reported to influence β-adrenergic sensitivity. 2. The aim of the present study was to determine the contribution of alterations in reflex changes in parasympathetic and sympathetic influences and physical fitness to the age-associated reduction in cardiac chronotropic responses to β-adrenergic agonists. 3. The effect of ‘autonomic blockade’ with atropine (40 μg/kg intravenously) and clonidine (4 μg/kg intravenously) on blood pressure, heart rate and chronotropic responses to intravenous bolus isoprenaline doses was determined in eight healthy young (mean age 21 years), nine healthy elderly (72 years) and 10 endurance-trained elderly (69 years) subjects. 4. Elderly subjects had a reduced increase in heart rate after atropine (young, 49 ± 9 beats/min; elderly, 36 ± 5 beats/min; endurance-trained elderly, 34 ± 12 beats/min; P < 0.01) and did not demonstrate the transient increase in systolic blood pressure after clonidine observed in young subjects (young, 11 ± 10 mmHg; elderly, −12 ± 16 mmHg; endurance-trained elderly, −18 ± 11 mmHg; P < 0.01). 5. Cardiac chronotropic sensitivity to isoprenaline after ‘autonomic blockade’ increased in the young but decreased in the elderly subjects. The isoprenaline dose that increased heart rate by 25 beats/min before and after autonomic blockade' was: young, before 1.6 μg, after 2.8 μg, P < 0.01 (geometric mean, paired test); elderly, before 6.9 μg, after 3.6 μg, P < 0.05; endurance-trained elderly, before 5.9 μg, after 4.0 μg, P < 0.05. Cardiac chronotropic sensitivity to isoprenaline was significantly reduced in elderly compared with young subjects before (P < 0.01) but was similar after (P = 0.09) ‘autonomic blockade’. Chronotropic sensitivity did not differ between healthy and endurance-trained elderly subjects before or after ‘autonomic blockade’. 6. The age-associated reduction in cardiac chronotropic responses to bolus isoprenaline is primarily due to an age-related reduction in the influence of reflex cardiovascular responses on heart rate and not to an age-related reduction in cardiac β-adrenergic sensitivity. Endurance training is not associated with altered β-adrenergic chronotropic sensitivity in the elderly. The transient pressor response to intravenously administered clonidine may be lost in ageing man.


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