Locomotive Syndrome Associated With Daily Moderate to Vigorous Physical Activity in Community‐dwelling Older Adults: A Cross-sectional Analysis

Background: Locomotive syndrome (LS) is associated with weakness and loss of function in the musculoskeletal organs. To evaluate the association between LS and daily physical activities (PA) in community-dwelling older adults using a three-axis accelerometer. Methods: This cross-sectional study included healthy 80 older adults (40 men and 40 women; age: 60-79 years). Three functional tests, the two-step test, the stand-up test, and the 25-question geriatric locomotive function scale (GLFS) were used to assess the risk of LS. Maximal isometric muscle strengths of the knee extensors were examined, and the weight bearing index (knee extension strength/body weight) was calculated. Habitual daily PA was evaluated using a three-axis wrist accelerometer. Results: Of the 80 participants, 41 (51.3%) fulfilled the diagnostic criteria for LS (including a two-step test score < 1.3, difficulty with one-leg standing from 40 cm in the stand-up test, and a 25-question GLFS score ≥ 7) We found that step count and time spent performing moderate to vigorous PA (MVPA) were significantly higher in women participants without LS compared to those with LS (p = 0.01); no significant difference was found in men. Logistic regression analyses indicated a longer time spent performing MVPA (> 47.26 min/day) was associated with a lower risk of LS compared to only performing for 21.11 min/day. Conclusions: Our data showed that daily MVPA using a three-axis accelerometer was associated with LS in community-dwelling older adult women, but not in men.

Recovery of Regular Daily Physical Activities Prevents Residual Dizziness after Canalith Repositioning Procedures

Objective: Residual dizziness is a disorder of unknown pathophysiology, which may occur after repositioning procedures for benign paroxysmal positional vertigo. This study evaluates the relationship between regular daily physical activity and the development of residual dizziness after treatment for benign paroxysmal positional vertigo. Study Design: Prospective observational cohort study. Setting: Academic university hospital. Methods: Seventy-one patients admitted with benign paroxysmal positional vertigo involving the posterior semicircular canal were managed with Epley’s procedure. Three days after successful treatment, the patients underwent a telephone interview to investigate vertigo relapse. If the patients no longer complained of vertigo, they were asked about symptoms consistent with residual dizziness. Subsequently, they were asked about the recovery of physical activities they regularly performed prior to the onset of vertigo. Results: Sixty-nine patients (age: 57.79 ± 15.05) were enrolled: five (7.24%) reported vertigo relapse whereas twenty-one of sixty-four non-relapsed patients (32.81%) reported residual dizziness. A significant difference in the incidence of residual dizziness was observed considering the patients’ age (p = 0.0003). Of the non-relapsed patients, 46 (71.88%) recovered their regular dynamic daily activities after treatment and 9 (19.57%) reported residual dizziness, while 12 of the 18 patients (66.67%) who did not resume daily activity reported residual symptoms (p = 0.0003). A logistic regression analysis showed a significant association between daily activity resumption and lack of residual dizziness (OR: 14.01, 95% CI limits 3.14–62.47; p = 0.001). Conclusions: Regardless of age, the resumption of regular daily physical activities is associated with a lack of residual dizziness.

A Randomized Controlled Trial Protocol for Using an Accelerometer-Smartphone Application Intervention to Increase Physical Activity and Improve Health among Employees in a Military Workplace

Physical activity is beneficial for improving health and reducing sick leave absences. This article describes a protocol for an intervention using an interactive accelerometer smartphone application, telephone counselling, and physical activity recordings to increase the physical activity of workers in the military and improve their health. Under the protocol, employees from six military brigades in Finland will be randomly assigned to intervention and control groups. The intervention group’s participants will use accelerometers to measure their daily physical activities and their quality of sleep for six months. They will receive feedback based on these measurements via a smartphone application. The intervention group’s participants will be encouraged to exercise for two hours per week during working hours, and to participate in telephone counselling. The control group’s participants will continue with their normal exercise routines, without the accelerometer or feedback. The participants of both groups will be measured at the baseline, after the intervention period, and six months after the end of the intervention. The measurements will include accelerometer recordings, biochemical laboratory tests, body composition measurements, physical fitness tests, and questionnaires on sociodemographic factors, physical activities, and health. The primary outcomes will indicate changes in physical activity, physical fitness, and sick leave absences. The findings will help to develop a straightforward and cost-effective model for supporting the health and working capabilities of employees in the military and other workplaces.

Expediting Finite Element Analyses for Subject-Specific Studies of Knee Osteoarthritis: A Literature Review

Osteoarthritis (OA) is a degenerative disease that affects the synovial joints, especially the knee joint, diminishing the ability of patients to perform daily physical activities. Unfortunately, there is no cure for this nearly irreversible musculoskeletal disorder. Nowadays, many researchers aim for in silico-based methods to simulate personalized risks for the onset and progression of OA and evaluate the effects of different conservative preventative actions. Finite element analysis (FEA) has been considered a promising method to be developed for knee OA management. The FEA pipeline consists of three well-established phases: pre-processing, processing, and post-processing. Currently, these phases are time-consuming, making the FEA workflow cumbersome for the clinical environment. Hence, in this narrative review, we overviewed present-day trends towards clinical methods for subject-specific knee OA studies utilizing FEA. We reviewed studies focused on understanding mechanisms that initiate knee OA and expediting the FEA workflow applied to the whole-organ level. Based on the current trends we observed, we believe that forthcoming knee FEAs will provide nearly real-time predictions for the personalized risk of developing knee OA. These analyses will integrate subject-specific geometries, loading conditions, and estimations of local tissue mechanical properties. This will be achieved by combining state-of-the-art FEA workflows with automated approaches aided by machine learning techniques.

Prospective randomised trial of bolus vs. continuous regime of jejunostomy feed

Enteral alimentation can be administered continuously, cyclically, intermittently, or by a bolus technique. Current literature does not suggest superiority of any one regime. Most studies have used nasogastric feeds, little is known about the outcome of jejunal feeding. This study compares the efficiency and safety of bolus and continuous jejunostomy feeding. 46 adults undergoing a feeding jejunostomy for nutritional support or as an adjunct to a major upper GI surgery, were randomised to bolus feeding (BF group, n = 24) and continuous feeding (CF group, n = 22). Demographic, anthropometric, and laboratory parameters were measured preoperatively and on post-operative days (POD) 3, 7, 15, and 30. These parameters; as well as nutritional and functional outcomes, and complications at POD 30; were comparable in both groups. Both groups tolerated jejunal feeds well. Bolus feeding is simple, inexpensive, and permits daily physical activities. Hence it may be preferred over continuous jejunostomy feeding for enteral alimentation.

Design of an early remote coaching program to bridge the gap from hospital discharge to the start of cardiac rehabilitation. (Preprint)

BACKGROUND Remote coaching might potentially be suited for providing information and support to patients with coronary artery disease (CAD) in the vulnerable phase between hospital discharge and the start of cardiac rehabilitation (CR). OBJECTIVE To explore and summarize information- and support needs of patients with CAD, and to develop an early remote coaching program providing tailored information and support. METHODS We used the intervention mapping (IM) approach to develop a remote coaching program. Three consecutive steps were completed in this study: (1) identification of information- and support needs in patients with CAD, using an exploratory literature study and semi-structured interviews; (2) definition of program objectives; (3) selection of theory-based methods and practical intervention strategies. RESULTS Our exploratory literature study (n=42) and semi-structured interviews (n=17) identified that after hospital discharge, patients with CAD report a need for tailored information and support about: CAD itself and the specific treatment procedures, medication and side effects, physical activity, and psychological distress. Based on the preceding steps, we defined the following program objectives: 1. Patients gain knowledge on how CAD and revascularization affects their bodies and health. 2. Patients gain knowledge about medication and side effects and adhere to their treatment plan. 3. Patients know which daily physical activities they can and can’t do safely after hospital discharge and are physically active. 4. Patients know the psychosocial consequences of CAD and know how to discriminate between harmful and harmless body signals. Based on the preceding steps, a remote coaching program was developed with the theory of health behavior change as theoretical framework, and behavioral counseling and video modelling as practical strategies for the program. CONCLUSIONS In this study we present the design of an early remote coaching program based on the needs of patients with CAD. The development of this program constitutes a step in the process of bridging the gap from hospital discharge to start of CR.

A qualitative research study in Japan investigating patients’ experience with metastatic castration-resistant prostate cancer: from diagnosis to decision for Ra-223 treatment

Aim: This qualitative study aimed to reveal symptoms and impacts among bone metastatic castration-resistant prostate cancer (or mCRPC) Japanese patients, prior to Radium-223 (Ra-223) treatment. Materials & Methods: Twenty-three mCRPC patients designated to receive Ra-223 and three treating physicians (Ra-223 prescribers) in Japan, were interviewed. All interview data were assessed for concept frequency, themes and saturation. Results: Forty-five percent of the patients (mean age: 75.8 years) were symptomatic at the time of enrollment. Interviews with all patients revealed 47 mCRPC symptoms, including back pain and bone-specific pain, and 45 life impacts, including worry about disease progression and the impact on daily, physical activities. Conclusion: The symptoms and impacts of living with mCRPC and the associated burden of bone metastasis and skeletal-related symptoms are varied and are important considerations for treatment.

Reliability of the weight-bearing ankle dorsiflexion range of motion measurement using a smartphone goniometer application

Background Weight-bearing ankle dorsiflexion range of motion measurement (weight-bearing lunge test) is gaining in popularity because it mimics lower extremity function in daily physical activities. The purpose of the study is to assess the intra-rater and the inter-rater reliability of the weight-bearing ankle dorsiflexion range of motion measurement with a flexed knee using a smartphone application Spirit Level Plus installed on an Android smartphone. Methods Thirty-two young, healthy subjects participated in the study and were measured in four sessions by two examiners. One measurement was taken on each ankle in every session. Eight measurements were taken from each participant. A total of 256 were taken from all the participants. The measurements for the individual subject were repeated no sooner than 24 hours after the first session. In order to assess the reliability, intraclass correlation coefficients (ICC), standard error measurements (SEM) and minimal detectable change (MDC) at the 95% confidence interval were calculated. Results Statistical data analysis revealed moderate intra-rater reliability for the right ankle (ICC = 0.72, 95% CI [0.49–0.85]) and good intra-rater reliability for the left ankle (ICC = 0.82, 95% CI [0.66–0.91]). Inter-rater reliability is moderate for the right (ICC = 0.73, 95% CI [0.52–0.86]) and the left ankle (ICC = 0.65, 95% CI [0.39–0.81]). Conclusion The observed method is moderately reliable and appropriate when the main objective is to assess ankle dorsiflexion mobility in weight-bearing when weight-bearing is not contraindicated. The concurrent validity of the Spirit Level Plus application is excellent.

Computational Analysis of Bone Remodeling in the Proximal Tibia Under Electrical Stimulation Considering the Piezoelectric Properties

The piezoelectricity of bone is known to play a crucial role in bone adaptation and remodeling. The application of an external stimulus such as mechanical strain or electric field has the potential to enhance bone formation and implant osseointegration. Therefore, in the present study, the objective is to investigate bone remodeling under electromechanical stimulation as a step towards establishing therapeutic strategies. For the first time, piezoelectric bone remodeling in the human proximal tibia under electro-mechanical loads was analyzed using the finite element method in an open-source framework. The predicted bone density distributions were qualitatively and quantitatively assessed by comparing with the computed tomography (CT) scan and the bone mineral density (BMD) calculated from the CT, respectively. The effect of model parameters such as uniform initial bone density and reference stimulus on the final density distribution was investigated. Results of the parametric study showed that for different values of initial bone density the model predicted similar but not identical final density distribution. It was also shown that higher reference stimulus value yielded lower average bone density at the final time. The present study demonstrates an increase in bone density as a result of electrical stimulation. Thus, to minimize bone loss, for example, due to physical impairment or osteoporosis, mechanical loads during daily physical activities could be partially replaced by therapeutic electrical stimulation.

Aktifitas Fisik, Riwayat Dismenore Keluarga dan Kecemasan dengan Dismenore pada Remaja

Introduction: Menstrual pain problems are problems that are often complained of by women, especially during their teens. This condition can get worse if accompanied by unstable psychological conditions, such as stress, depression, excessive anxiety, and excessive sadness or happiness. Objectives: The purpose of this study was to determine the relationship of physical activity, family history of dysmenorrhea and anxiety with dysmenorrhea in adolescents at SMK Wijaya Kusuma, South Jakarta in 2020. Method: The design of this study used analytical methods with cross sectional research designs. The population of this research is the Young Women at Smk Wijaya Kusuma. So the sample needed is 86 respondents. Result: Chi square hypothesis test results obtained p-value of 0.035, it can be concluded that there is a relationship between physical activity and dysmenorrhea in adolescents at SMK Wijaya Kusuma, South Jakarta in 2020. In addition, an Odds Ratio (OR) score of 3.874 means that respondents routinely perform physical activity had 3,874 times the chance to experience mild dysmenorrhea compared with respondents who did not routinely engage in physical activity. There is a relationship of anxiety towards dysmenorrhea in adolescents in Smk Wijaya Kusuma, South Jakarta in 2020 with a p-value of 0.012 and an Odds Ratio (OR) of 3.539. Conclution: The conclusion is that there is a relationship between physical activity, family history of dysmenorrhea and anxiety with dysmenorrhea in adolescents at SMK Wijaya Kusuma, South Jakarta in 2020. Suggestions for adolescents to be able to routinely carry out daily physical activities such as exercising and doing homework in order to reduce dysmenorrhea.