Is achieving 7,000 steps/day cross-sectionally and prospectively associated with older adults’ lower-extremity performance?

Background Evidence regarding the association between daily steps recommendation and older adults’ lower limb strength is lacking; thus, this study investigated whether taking at least 7,000 steps/day is cross-sectionally and prospectively related to lower-extremity performance in older Taiwanese adults. Methods There were 89 community-dwelling adults aged over 60 years (mean age: 69.5 years) attending both baseline and follow-up surveys. This study used adjusted logistic regression analysis to explore cross-sectional and prospective relationships between their accelerometer-assessed daily steps and lower-extremity performance (five-times-sit-to-stand test). Results This study found the older adults who took 7,000 steps/day were more likely to have better lower-extremity performance cross-sectionally (odds ratio [OR] = 3.82; 95 % confidence interval [CI]: 1.04, 13.95; p = 0.04), as well as to maintain or increase their lower-extremity performance prospectively (OR = 3.53; 95 % CI: 1.05, 11.84; p = 0.04). Conclusions Our findings support a minimum recommended level of step-based physical activity for older adults, namely, 7,000 steps/day, as beneficial for maintaining or increasing older adults’ lower-extremity performance.

Medial tibial stress syndrome: The relationship between gender and lower-extremity functional performance among collegiate track and field athletes

Medial tibial stress syndrome (MTSS) is a common lower extremity injury in track and field athletes. Many risk factors are associated with MTSS, and lower extremity performance may become altered in athletes suffering from prior symptoms, potentially increasing risk of future injury. The purpose of this study was to first examine the effect a prior history of MTSS has on lower-extremity measures, per gender, in collegiate level track and field athletes, and then determine if such measures predict future injury. Fifty-three healthy Division III collegiate track and field athletes (mean age = 19.40 ± 1.13 years) completed an injury history questionnaire along with five preseason lower-extremity functional tests including: ankle dorsiflexion (DF), single-leg anterior reach (SLAR), two timed single-leg balance (SLBAL) tests on a force plate, and single-leg hop for distance (SLH). Performance data were compared across gender and questionnaire data regarding injury history and occurrence of MTSS. Fifteen subjects (28%) reported previous MTSS symptoms within the last 2 years. Chi-square analyses revealed females experienced more diagnoses compared to males (p = .03). Independent t-tests revealed differences between gender on all SLBAL tests, as males performed better on all recorded measures (p < .001 – p = .003). No significant differences were noted in lower-extremity performance tests between subjects with and without prior MTSS injuries. Regression analyses using postseason injury questionnaire data revealed prior MTSS injuries had 17.3 higher odds of experiencing MTSS during the season (adjusted odds ratio [AOR] = 17.33, 95% CI: 3.5 – 86.4; p = .001).

Is achieving 7,000 steps/day cross-sectionally and prospectively associated with older adults’ lower-extremity performance?

Background: Evidence regarding the association between daily steps recommendation and older adults’ lower limb strength is lacking; thus, this study investigated whether taking at least 7,000 steps/day is cross-sectionally and prospectively related to lower-extremity performance in older Taiwanese adults. Methods: There were 89 community-dwelling adults aged over 60 years (mean age: 69.5 years) attending both baseline and follow-up surveys. This study used adjusted logistic regression analysis to explore cross-sectional and prospective relationships between their accelerometer-assessed daily steps and lower-extremity performance (five-times-sit-to-stand test). Results: This study found the older adults who took 7,000 steps/day were more likely to have better lower-extremity performance cross-sectionally (odds ratio [OR] = 3.82; 95% confidence interval [CI]: 1.04, 13.95; p = 0.04), as well as to maintain or increase their lower-extremity performance prospectively (OR=3.53; 95% CI: 1.05, 11.84; p = 0.04). Conclusions: Our findings support a minimum recommended level of step-based physical activity for older adults, namely, 7,000 steps/day, as beneficial for maintaining or increasing older adults’ lower-extremity performance.

Is achieving 7,000 steps/day associated with older adults’ lower-extremity performance? Cross-sectional and prospective findings from Taiwan

Background: Evidence regarding the association between daily steps recommendation and older adults’ lower limb strength is lacking; thus, this study investigated whether taking at least 7,000 steps/day is cross-sectionally and prospectively related to lower-extremity performance in older Taiwanese adults. 89 community-dwelling adults aged over 60 years (mean age: 69.5 years) who attended both baseline and follow-up surveys. Methods: This study used adjusted logistic regression analysis to explore cross-sectional and prospective relationships between their accelerometer-assessed daily steps and lower-extremity performance (five-times-sit-to-stand test). Results: This study found the older adults who took 7,000 steps/day were more likely to have better lower-extremity performance cross-sectionally (odds ratio [OR] = 3.82; 95% confidence interval [CI]: 1.04, 13.95; p = 0.04), as well as to maintain or increase their lower-extremity performance prospectively (OR=3.53; 95% CI: 1.05, 11.84; p = 0.04). Conclusions: Our findings support a minimum recommended level of step-based physical activity for older adults, namely, 7,000 steps/day, as beneficial for maintaining or increasing older adults’ lower-extremity performance.

Effect of Injury Prevention Programs on Lower Extremity Performance in Youth Athletes: A Systematic Review

Background: Understanding how existing youth injury prevention programs affect specific modifiable injury risk factors will inform future program development for youth athletes. Objective: To comprehensively evaluate the effects of injury prevention programs on the modifiable intrinsic risk factors associated with lower extremity performance in youth athletes. Data Sources: This systematic review followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A systematic search of the literature was performed using multiple databases (PubMed, EBSCOhost [including CINAHL, Medline, and SPORTDiscus], and PEDro). Secondary references were appraised for relevant articles. Article types included randomized or cluster randomized controlled trials and randomized cohort designs with youth athletes engaged in organized sports, along with outcomes that included at least 1 physical performance outcome measure. Study Selection: Eight studies met inclusion and exclusion criteria and were reviewed by 2 independent reviewers, with a third consulted in the case of disagreement, which was not needed. Study Design: Systematic review. Level of Evidence: Level 3. Data Extraction: Included studies underwent review of methodological quality using the Physiotherapy Evidence Database scale. Results: Studies included mixed-sex samples of youth athletes who predominantly participated in soccer at different skill levels. The FIFA 11+ series was the most commonly used injury prevention program. Among studies, the mean percentage of improvement identified was 11.3% for force generation, 5.7% for coordination, 5.2% for posture, and 5.2% for balance. The lowest mean percentage improvement was in speed (2.2%). Endurance was not significantly affected by any of the programs. Conclusion: This systematic review shows that injury prevention programs improve several modifiable intrinsic risk factors of lower extremity performance among youth athletes, particularly force generation. However, several intrinsic risk factors were either not significantly affected or specifically addressed by existing programs.

Complex Tears, Extrusion, and Larger Excision Are Prognostic Factors for Worse Outcomes 1 and 2 Years After Arthroscopic Partial Meniscectomy for Degenerative Meniscal Tears: A Secondary Explorative Study of the Surgically Treated Group From the Odense-Oslo Meniscectomy Versus Exercise (OMEX) Trial

Background: Few studies have examined morphological findings from preoperative magnetic resonance imaging (MRI) and arthroscopic findings as prognostic factors for outcomes 1 and 2 years after arthroscopic partial meniscectomy (APM). Purpose/Hypothesis: The purpose was to evaluate prognostic factors of preoperative findings from MRI and arthroscopic evaluation on lower extremity performance at 1 year and patient-reported outcomes at 1 to 2 years after APM. The hypothesis was that medial compartment abnormalities would be prognostic for 1- and 2-year functional outcomes. Study Design: Cohort study; Level of evidence, 2. Methods: This secondary analysis from the OMEX (Odense-Oslo Meniscectomy Versus Exercise) trial included 40 patients treated surgically. Regression analyses with adjustments for age, sex, and body mass index explored associations between MRI findings (tear complexity and extrusion), arthroscopic findings (tear length, cartilage injury, and amount of excised meniscal tissue), and the following: lower extremity performance tests and thigh muscle strength at 1 year and the 5 Knee injury and Osteoarthritis Outcome Score (KOOS) subscales at 1 and 2 years. Results: A complex meniscal tear was a significant and clinically relevant prognostic factor for worse KOOS Symptoms subscores at 2 years (mean, 14.1 points [95% CI, 6.1-22.2]). Meniscal extrusion of at least 11%, 25%, and 20% were significant and clinically relevant prognostic factors for worse KOOS Activities of Daily Living (ADL) subscores at 1 year and worse KOOS Sports and Recreation (Sports/Rec) subscores at 1 and 2 years, respectively. Tear lengths of at least 7.0 mm, 6.7 mm, and 6.5 mm were significant and clinically relevant prognostic factors for better KOOS Symptoms subscores at 1 year and better KOOS Sports/Rec subscores at 1 and 2 years, respectively. A cartilage injury in the medial compartment was a significant and clinically relevant prognostic factor for worse KOOS ADL and Quality of Life (QoL) subscores at 2 years (mean, 10.4 and 19.4 points, respectively [95% CI, 3.4-17.4 and 7.7-31.1, respectively]). More than 20% meniscal tissue excised was a significant and clinically relevant prognostic factor for worse KOOS Pain, Symptoms, ADL, and Sports/Rec subscores at 1 and 2 years (mean, 8.9-41.5 points [95% CI, 2.2-15.5 to 21.0-62.0]) and worse KOOS QoL subscores at 2 years (mean, 25.3 points [95% CI, 13.6-37.0]). Conclusion: Complex meniscal tears, larger extrusion, cartilage injuries, and larger meniscal excision were significant and clinically relevant prognostic factors for worse outcomes 1 and 2 years after APM. Registration: NCT01002794 (ClinicalTrials.gov identifier)

Development of a Concise Lower Extremity Physical Performance Test Set for Return to Sport Decision-Making in Pediatric Populations

Objectives: Physical performance tests (PPT’s) are used to assess lower extremity function in pediatric populations. Common PPT’s include the lower quarter Y-balance, stork balance, stork balance on BOSU, single leg squat (SLS), SLS on BOSU, clockwise and counterclockwise quadrant single leg hop (SLH), forward SLH, timed SLH, and triple crossover SLH. Each of these tests assesses distinct performance characteristics, but administration of the full 10-item test battery is not practical. The aims of this analysis were to 1) define the primary underlying components of physical performance assessed by these 10 PPT’s, and 2) derive a reduced item set of PPTs that efficiently and accurately measures performance on each underlying component. Methods: This study included healthy, uninjured volunteers (n=61) between the ages 6 and 17 [mean age = 10.7 ±3.2 years; 33 females (54.1%)]. After a brief warm-up, subjects performed the 10 PPT’s in the same order (listed above), however we randomly assigned the starting test to avoid practice/fatigue effects. Subjects completed 2 trials on each leg for each test with the exception of the SLH tests, which were performed 3 times. We developed a composite score for each test by averaging trials across sides. Prior to item reduction, all Y-balance, and hop tests were normalized to leg length. Item reduction was performed using principal components analysis (PCA) with oblique rotation (Promax) on all 10 tests. We used the Kaiser criterion (eigenvalue > 1) to determine the optimal number of components. Items with loadings > 0.55 were considered for the reduced test item set. Cross-loaded items with < 0.25 absolute difference in loading between components were dropped. If two or more factors loading on the same component were highly correlated (r > 0.7), we dropped the item(s) with the lowest factor loading. Results: The PCA identified 2 components. Component 1 (neuromuscular control/balance) included all balance, single leg squat and quadrant hop test items. The 2 quadrant hop tests were highly correlated (r=0.94), had the second and third lowest factor loadings on the component (<0.78), and were dropped. The SLS test had the lowest factor loading (0.69) and was also dropped. The Stork, Stork BOSU, and SLS BOSU had similar factor loadings (0.79, 0.90, and 0.88, respectively) and did not meet the correlation criterion for removal (all < 0.61). Component 2 (Power) included the forward SLH and Crossover SLH. Each demonstrated high factor loadings (0.94 and 0.79, respectively) and only moderate correlation (r=0.56). The Timed SLH and lower quarter Y-balance did not meet the loading criterion and were dropped. The final 5-item PPT set had a cumulative response variance of 76.0%. The internal consistency (Cronbach α) of the 3-item Component 1 (0.80), 2-item Component 2 (0.72) and overall 5-item set (0.70) were all satisfactory (i.e., > 0.7). Conclusion: The 10 PPT’s measure 2 primary components of lower extremity performance: neuromuscular control/balance and power. These components are most appropriately assessed with the stork balance, stork BOSU, SLS BOSU, forward SLH and triple crossover SLH tests. Of these, the Stork BOSU and forward SLH are most capable of evaluating the 2 components. These findings provide clinicians with efficient options for measuring lower extremity performance in pediatric populations. Future studies should determine whether tests excluded from the reduced-item set provide important prognostic information for clinical outcomes. [Table: see text]