scholarly journals The clinically important changes physical function were not associated with clinically important changes in muscle strength or physical performance over time - A Cohort Study

2021 ◽  
Author(s):  
Cavalheiro do Espírito Santo Rafaela ◽  
Joshua F Baker ◽  
Jordana Miranda de Souza Silva ◽  
Lidiane Isabel Filippin ◽  
Juliana Katarina Schoer Portes ◽  
...  
BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e042786
Author(s):  
Rikke S Kamper ◽  
Martin Schultz ◽  
Sofie K Hansen ◽  
Helle Andersen ◽  
Anette Ekmann ◽  
...  

IntroductionSarcopenia is generally used to describe the age-related loss of muscle mass and strength believed to play a major role in the pathogenesis of physical frailty and functional impairment that may occur with old age. The knowledge surrounding the prevalence and determinants of sarcopenia in older medical patients is scarce, and it is unknown whether specific biomarkers can predict physical deconditioning during hospitalisation. We hypothesise that a combination of clinical, functional and circulating biomarkers can serve as a risk stratification tool and can (i) identify older acutely ill medical patients at risk of prolonged hospital stays and (ii) predict changes in muscle mass, muscle strength and function during hospitalisation.Method and analysisThe Copenhagen PROTECT study is a prospective cohort study consisting of acutely ill older medical patients admitted to the acute medical ward at Copenhagen University Hospital, Bispebjerg and Frederiksberg, Denmark. Assessments are performed within 24 hours of admission and include blood samples, body composition, muscle strength, physical function and questionnaires. A subgroup of patients transferred to the Geriatric Department are included in a smaller geriatric cohort and have additional assessments at discharge to evaluate the relative change in circulating biomarker concentrations, body composition, muscle strength and physical function during hospitalisation. Enrolment commenced 4 November 2019, and proceeds until August 2021.Ethics and disseminationThe study protocol has been approved by the local ethics committee of Copenhagen and Frederiksberg (H-19039214) and the Danish Data Protection Agency (P-2019-239) and all experimental procedures were performed in accordance with the Declaration of Helsinki. Findings from the project, regardless of the outcome, will be published in relevant peer-reviewed scientific journals in online (www.clinicaltrials.gov).Trial registration numberNCT04151108


2017 ◽  
Vol 27 (5) ◽  
pp. 579-596 ◽  
Author(s):  
E. Segura-Ortí ◽  
P. L. Gordon ◽  
J. W. Doyle ◽  
K. L. Johansen

The aim of this study was to determine the extent to which poor physical functioning, low participation in physical activity, and muscle atrophy observed among patients on hemodialysis are evident in the earlier stages of chronic kidney disease (CKD). We enrolled adults in three groups: no CKD, Stages 3 to 4 CKD, and hemodialysis. Outcomes measured were physical activity, muscle size, thigh muscle strength, physical performance, and self-reported physical function. Patients with CKD had muscle area intermediate between the no CKD and hemodialysis groups, but they had low levels of physical activity that were similar to the hemodialysis group. Physical activity and muscle size were significantly associated with all outcomes. Kidney function was not significantly associated with muscle strength or physical performance after adjustment for physical activity and muscle size. In conclusion, interventions aimed to increase muscle mass and energy expenditure might have an impact on improving physical function of CKD patients.


PeerJ ◽  
2017 ◽  
Vol 5 ◽  
pp. e3768 ◽  
Author(s):  
Samantha Fien ◽  
Mike Climstein ◽  
Clodagh Quilter ◽  
Georgina Buckley ◽  
Timothy Henwood ◽  
...  

Once the general decline in muscle mass, muscle strength and physical performance falls below specific thresholds, the middle aged or older adult will be diagnosed as having sarcopenia (a loss of skeletal muscle mass and strength). Sarcopenia contributes to a range of adverse events in older age including disability, hospitalisation, institutionalisation and falls. One potentially relevant but understudied population for sarcopenia researchers would be Masters athletes. Masters sport is becoming more common as it allows athletes (typically 40 years and older) the opportunity to participate in individual and/or team sports against individuals of similar age. This study examined a variety of measures of anthropometric, physical function and general health markers in the male and female Masters athletes who competed at the 2014 Pan Pacific Masters Games held on the Gold Coast, Australia. Bioelectrical impedance analysis was used to collect body fat percentage, fat mass and fat-free mass; with body mass, height, body mass index (BMI) and sarcopenic status also recorded. Physical function was quantified by handgrip strength and habitual walking speed; with general health described by the number of chronic diseases and prescribed medications. Between group analyses utilised ANOVA and Tukey’s post-hoc tests to examine the effect of age group (40–49, 50–59, 60–69 and >70 years old) on the outcome measures for the entire sample as well as the male and female sub-groups. A total of 156 athletes (78 male, 78 female; mean 55.7 years) provided informed consent to participate in this study. These athletes possessed substantially better anthropometric, physical function and general health characteristics than the literature for their less physically active age-matched peers. No Masters athletes were categorised as being sarcopenic, although one participant had below normal physical performance and six participants had below normal muscle strength. In contrast, significant age-related reductions in handgrip strength and increases in the number of chronic diseases and prescribed medications were observed for the overall cohort as well as the male and female sub-groups. Nevertheless, even those aged over 70 years only averaged one chronic disease and one prescribed medication. These results may suggest that participation in Masters sport helps to maintain anthropometry, physical function and general health in middle-aged and older adults. However, it is also possible that only healthier middle-aged and older adults with favourable body composition and physical function may be able to participate in Masters sport. Future research should therefore utilise longitudinal research designs to determine the health and functional benefits of Master sports participation for middle-aged and older adults.


Author(s):  
Katie Thralls Butte ◽  
Susan S. Levy

Objectives: To examine the efficacy of an the intervention Stand Up Now (SUN) to reduce sedentary behavior (SB) and improve physical function and mobility. Methods: SUN included two groups: (a) focused on reducing total SB (SUNSL) and (b) focused on increasing sit-to-stand (STS) transitions (SUNSTS). The participants (N = 71; Mage = 87 ± 7 years) had 12 weekly health coaching sessions. SB, physical function, and mobility were measured at the baseline, 6, and 12 weeks via the activPAL, Short Physical Performance Battery, and the 8-foot up and go, respectively. Linear mixed models examined the outcome variables over time. Results: Both groups decreased sedentary time (1.3 ± 0.3 hr, p < .001), increased standing time (0.5 ± 0.2 hr, p < .02), and improved physical function (1.5 ± 0.4 points, p < .001) from the baseline to 6 weeks, and they maintained it at 12 weeks. SUNSTS increased STS transitions (5.4 ± 4.1, p < .001), while SUNSL had no changes (0.5 ± 3.1, p > .9). There were no changes in mobility for either group (0.5 ± 1.5 s, p > .05). Discussion: SUN demonstrates the efficacy to improve SB and physical function in older adults.


2020 ◽  
Vol 6 ◽  
pp. 233372142093570
Author(s):  
Hungu Jung ◽  
Yumiko Miki ◽  
Ryo Tanaka ◽  
Masahiro Yamasaki

Objective: We aimed to examine the outcomes of our novel multicomponent lower extremity training (MLT) technique on physical function in older adults. Methods: Participants were randomly divided into a training group (TG) or a control group (CG). The TG (4 men, 14 women) received MLT for 24 weeks, once per week. MLT contains strength, balance, and flexibility components. The CG (5 men, 10 women) did not receive any training for 24 weeks. Nine lower extremity range of motions (ROMs; hip flexion, hip abduction, hip adduction, hip extension, internal and external hip rotations, knee flexion, ankle dorsiflexion, and ankle plantar flexion) and two muscle strength assessments (knee extension and flexion) were collected. Physical performance tests were also performed, including the functional reach test, timed up and go test (TUGT), and five times sit-to-stand test (FTSST). Results: After 24 weeks, significant increases were observed in the TG in all ROMs (with the exception of knee flexion), knee extension strength, and performance in the TUGT and FTSST. Conclusions: MLT significantly improved ROM, muscle strength, and physical performance in healthy older adults. We suggest that it is an efficacious intervention in the maintenance and improvement of mobility and functional independence in healthy older adults. Trial registration: UMIN CTR, UMIN000037463. https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000041955


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