Customized Arch Support Insoles Improve Physical Functional Performance in Children: A Randomized Controlled Study

The effectiveness of arch-support insoles on children remains controversial. We evaluated the short-term therapeutic effects of arch-support insoles on the physical functional performance, physical function, and psychological well-being of healthy children under the International Classification of Functioning, Disability, and Health (ICF) framework. It was a prospective double-blind randomized controlled study. The participants were randomized into 2 groups, the treatment group (with customized arch-support insoles) and the control group (without insoles) for a 12-week intervention period. The walking speed test, stairs ascent and descent tests, the Five Times Sit-to-Stand test, and the Timed Up and Go test for physical functional performance, and the Pediatric Outcome Data Collection Instrument-Parent (PODCI) and the Child Health Questionnaire-Parent Form (CHQ-PF28) for the physical function and psychological well-being of children were assessed. Forty-five children completed the study. Compared with the control group, after 12 weeks of wearing customized insoles, the treatment group exhibited significant improvement in physical functional performance in terms of fastest walking speed (effect size: .515, P = .046), stairs ascent time (effect size: .658, P = .023), and stairs descent time (effect size: .718, P = .012). No significant difference was found between PODCI and CHQ-PF28 scores.Conclusions: Children wearing customized arch-support insoles for 12 weeks improved their physical functional performance which belonged to the domain of activity in the ICF. However, using insoles did not affect the physical function and psychological well-being of children.ClinicalTrials.gov (NCT03198299), date of registration: June 2017, retrospectively registered.

Abstract 031: Age-related Homeostatic Dysregulation In Midlife And Physical Function In Late Life: The Atherosclerosis Risk In Communities (aric) Study

Introduction: Age-related homeostatic dysregulation (Dm), characterized by multi-biomarker composite measures, has shown promise as a rate-of-aging metric. We tested the association of midlife Dm and its change over ~20 years of follow-up with later life physical function. Methods: We studied 4617 ARIC cohort participants (mean age 54.8 years, 58% female, 20% Black) who completed in-person examinations from 1990-92 (baseline) through 2011-13. Dm quantifies the multivariate statistical deviation of 15 physiology-motivated biomarkers from the distribution in a healthy sample at baseline. Midlife Dm was grouped by quartiles (higher quartiles indicating greater homeostatic dysregulation) and temporal change in Dm was quantified continuously. Physical function was assessed in 2011-13 and included measures from the Short Physical Performance Battery (SPPB) including repeated chair stands, balance, 4-meter walk and grip strength. Associations were quantified using linear regression and ordinal logistic regression as applicable, adjusting for age, sex, race, and education. Results: A graded association was observed between midlife Dm and physical functional performance in late life (Table). Compared to the 1 st quartile of midlife Dm, the odds ratio of a lower SPPB score in late life was 1.19 (95%CI 1.04, 1.35) for the 2 nd quartile, 1.63 (1.41, 1.90) for the 3 rd quartile, and 3.14 (2.60, 3.79) for the 4 th quartile. Similar associations were observed for each of SPPB components and grip strength, either modeled ordinally or continuously. Each standard deviation increase in 10-year Dm change was associated with ~2-3 times the odds of having a poorer physical functional performance. Conclusions: Greater homeostatic dysregulation at midlife and increases in dysregulation during follow-up were associated with poorer physical function in late life. Insights into the factors that lead to progression of multisystem deterioration during midlife may highlight opportunities to preserve functional abilities in late life.

Physical functional performance and prognosis in patients with heart failure: a systematic review and meta-analysis

Background Patients with Heart Failure (HF) show impaired functional capacities which have been related to their prognosis. Moreover, physical functional performance in functional tests has also been related to the prognosis in patients with HF. Thus, it would be useful to investigate how physical functional performance in functional tests could determine the prognosis in patients with HF, because HF is the leading cause of hospital admissions for people older than 65 years old. This systematic review and meta-analysis aims to summarise and synthesise the evidence published about the relationship between physical functional performance and prognosis in patients with HF, as well as assess the risk of bias of included studies and the level of evidence per outcome. Methods Major electronic databases, such as PubMed, AMED, CINAHL, EMBASE, PEDro, Web of Science, were searched from inception to March 2020 for observational longitudinal cohort studies (prospective or retrospective) examining the relationship between physical functional performance and prognosis in patients with HF. Results 44 observational longitudinal cohort studies with a total of 22,598 patients with HF were included. 26 included studies reported a low risk of bias, and 17 included studies showed a moderate risk of bias. Patients with poor physical functional performance in the Six Minute Walking Test (6MWT), in the Short Physical Performance Battery (SPPB) and in the Gait Speed Test showed worse prognosis in terms of larger risk of hospitalisation or mortality than patients with good physical functional performance. However, there was a lack of homogeneity regarding which cut-off points should be used to stratify patients with poor physical functional performance from patients with good physical functional performance. Conclusion The review includes a large number of studies which show a strong relationship between physical functional performance and prognosis in patients with HF. Most of the included studies reported a low risk of bias, and GRADE criteria showed a low and a moderate level of evidence per outcome.

Effectiveness Of Structured Exercise Protocol On Functional Performance In Subjects With Covid-19

It is a well-established fact that patients of Covid 19 have musculoskeletal dysfunctions in addition to cardiorespiratory and psychosocial problems. Musculoskeletal system is amongst the most common systems found to be affected in patients admitted in ICU for prolonged periods and some patients of Covid 19 do have to spend a reasonably long period in ICU’s. Prolonged hospital stay may be needed in Covid 19 patients having ARDS or pneumonia and symptoms of fever, cold and cough to monitor their recovery. This may result in musculoskeletal dysfunctions as demonstrated in some studies. Thus, treating the musculoskeletal system becomes a vital part of the regimen to be followed during the patients stay in the ICU which needs to be followed up even after the patient is shifted from the ICU by keeping a track of Physical Functional performance of the subjects after discharge. This experimental study was done on 150 Covid-19 positive subjects to see the long term effectiveness of a structured exercise protocol on the Physical Functional performance of Covid 19 patients. The results of the study were analysed statistically and both the outcome measures FIMS and POMA showed significant changes with p value <0.05 and <0.05 respectively. The study thus shows that the structured exercise protocol helped in maintaining the Physical Functional performance of the subjects through-out the hospital stay and also after discharge during follow up.

Twelve-week intradialytic cycling exercise improves physical functional performance with gain in muscle strength and endurance: a randomized controlled trial

Objective: To evaluate the effect of intradialytic cycling exercise on physical functional performance with gain in muscle strength and endurance in end-stage renal disease patients with haemodialysis. Design: Randomized controlled trial, with repeated measurements at baseline and after 4, 8, and 12 weeks of intradialytic cycling exercise. Setting: A 50-bed haemodialysis centre in a regional hospital in Taiwan. Subjects: Seventy-six regular haemodialysis patients, recruited and equally and randomly assigned to exercise and control groups. Intervention: The intradialytic cycling exercise was performed for 12 weeks and comprised warm-up, main, and cool-down exercise phases. A stationary cycling equipment was used, which involved aerobic and resistance modalities. The intensity was maintained at somewhat hard exertion. Each intradialytic cycling exercise was implemented for 30 minutes, starting at the second hour of treatment. Main measure: Measured outcomes were 6-minute walk distance, time taken to complete 10 sit-to-stand-to-sit cycles and number of sit-to-stand-to-sit cycles in 60 seconds. Results: Average (standard deviation) participant age was 55.47 (13.00) years. Therefore, the 6-minute walk distance was significantly different at weeks 8 ( P = 0.01) and 12 ( P < 0.001) in the exercise group compared with that in the control group at baseline. Notably, sit-to-stand-to-sit outcomes ( P = 0.01) significantly influenced the 6-minute walk distance. Sit-to-stand-to-sit outcomes significantly improved in the exercise group ( P < 0.05). Conclusion: Twelve-week intradialytic exercise for patients on haemodialysis can improve physical functional performance with gain muscle strength and endurance. This is a safe and effective method for improving health.

Multi-components exercise associated with dual task: Effects on physical functional performance and mobility of the older adults

Objective: The aim of this study was to verify the effect of dual task in a training protocol in the components of physical Functional Performance and mobility of older adults Methods: Thirty older adults (twenty-three female and seven males; 66.48 ±3.85 years) were distributed into three randomized groups: Multi-component physical activity group (MC), Dual Task Group (DT) and Control Group (CG). Participants were assessed before training and after 12 weeks of training with the following tests: Mini Mental State Examination, for evaluation of cognitive functions, AAHPERD test battery - American Alliance for Health, Physical Education, Recreation and Dance, for evaluation of five physical Functional Performance components, Timed Up and Go, for evaluation of functional mobility and The Baecke Questionnaire to assess the level of physical activity. Both MC and DT groups performed the same multi-components training protocol, however DT group performed simultaneously with a second cognitive task. Results: The groups that performed the training protocol improved some aspects of physical Functional Performance and mobility compared to the CG (p < 0.01). No difference was found between the DT and MC groups. Conclusion: Performing two simultaneous tasks in a training protocol does not seem to influence the functional capacity and mobility.Keywords: dual task training, multi-components training, physical functional performance