Hospital Acquired Deconditioning in Older AdultsChris Hattersley
Evidence based information on hospital acquired deconditioning in older adults, links to any studies referenced are included in the notes section of the presentation slides.
AHS13 James Steel — An Ancient Perspective on Deconditioning in Low Back Pain Ancestral Health Society
Low back pain (LBP) is a multifactorial issue that is prevalent across most human populations, westernised, rural and indigenous. Deconditioning of the lumbar extensor musculature is a commonly associated factor and has been shown prospectively to be a risk factor for development of LBP. Here an explanation concerning lumbar spine and pelvic anatomic evolution is offered in attempt to integrate these findings. It appears that anatomically modern humans may be predisposed to LBP as a consequence of their evolutionary heritage; the compromise of relatively strong hip/trunk extensors and relatively weak lumbar extensors in combination with a long flexible lumbar spine.
Mal-Alignment as a Risk Factor for Lower Extremity Overuse Injuries: A Case C...iosrjce
Engaging in sports activities has various health benefits, but also carries the risk of injury. Overuse
injuries in young adults is one of them which is challenge to the treating clinician. In the present study, we
studied the association of mal-alignment as a risk factor for overuse injuries of lower extremity in young adults.
In this prospective case-control study, we enrolled all the adult patients engaged in unorganised sports activity
presented with various lower extremity overuses injuries as cases and the without any overuse injury as
controls. After making a clinical impression, all patients were subjected to relevant X-rays to diagnose the malalignment,
if present or not. A total of 471 cases and 857 controls with overuse injuries were included. The
mean age at diagnosis of overuse injuries was 25.5(16-30) yrs in cases and 24.3 (18-30) yrs in controls. The
recreational running was the commonest unorganized activity in both males (38.2%) and females (62.5%).
Correlation of the mal-alignment with overuse injuries found to be statistically significant (p=0.003). In
conclusion overuse injuries in young adults are significantly associated with mal-alignments. Better
understanding of these mal-alignments is better for the management of these injuries.
Strength training is not just for bodybuilding anymore. There is so much more to it than pure appearance aspect. Anyone who is serious about getting more life out of their years should seriously consider engaging in the safe strength training routine.
Most strength training methods, as practiced in the 'box gyms', are not very safe, are time consuming and not necessarily health improving. This presentation talks about a 30,000 foot view of some of the key quality of life, health, fitness and appearance benefits safe strength training has to offer. In addition, it highlights some key aspects of how it could be practiced safely and suitably.
Hospital Acquired Deconditioning in Older AdultsChris Hattersley
Evidence based information on hospital acquired deconditioning in older adults, links to any studies referenced are included in the notes section of the presentation slides.
AHS13 James Steel — An Ancient Perspective on Deconditioning in Low Back Pain Ancestral Health Society
Low back pain (LBP) is a multifactorial issue that is prevalent across most human populations, westernised, rural and indigenous. Deconditioning of the lumbar extensor musculature is a commonly associated factor and has been shown prospectively to be a risk factor for development of LBP. Here an explanation concerning lumbar spine and pelvic anatomic evolution is offered in attempt to integrate these findings. It appears that anatomically modern humans may be predisposed to LBP as a consequence of their evolutionary heritage; the compromise of relatively strong hip/trunk extensors and relatively weak lumbar extensors in combination with a long flexible lumbar spine.
Mal-Alignment as a Risk Factor for Lower Extremity Overuse Injuries: A Case C...iosrjce
Engaging in sports activities has various health benefits, but also carries the risk of injury. Overuse
injuries in young adults is one of them which is challenge to the treating clinician. In the present study, we
studied the association of mal-alignment as a risk factor for overuse injuries of lower extremity in young adults.
In this prospective case-control study, we enrolled all the adult patients engaged in unorganised sports activity
presented with various lower extremity overuses injuries as cases and the without any overuse injury as
controls. After making a clinical impression, all patients were subjected to relevant X-rays to diagnose the malalignment,
if present or not. A total of 471 cases and 857 controls with overuse injuries were included. The
mean age at diagnosis of overuse injuries was 25.5(16-30) yrs in cases and 24.3 (18-30) yrs in controls. The
recreational running was the commonest unorganized activity in both males (38.2%) and females (62.5%).
Correlation of the mal-alignment with overuse injuries found to be statistically significant (p=0.003). In
conclusion overuse injuries in young adults are significantly associated with mal-alignments. Better
understanding of these mal-alignments is better for the management of these injuries.
Strength training is not just for bodybuilding anymore. There is so much more to it than pure appearance aspect. Anyone who is serious about getting more life out of their years should seriously consider engaging in the safe strength training routine.
Most strength training methods, as practiced in the 'box gyms', are not very safe, are time consuming and not necessarily health improving. This presentation talks about a 30,000 foot view of some of the key quality of life, health, fitness and appearance benefits safe strength training has to offer. In addition, it highlights some key aspects of how it could be practiced safely and suitably.
Feasibility Study for evaluating the effectiveness of Orient inertial 3D motion capture wireless devices (developed by the Speckled Computing research group at the University of Edinburgh) for human gait analysis and for identifying deviations from normal gait
The primary onset of this study is to determine the short and longer term effects of dual task training gait on walking performance when dual tasking in people with Parkinson’s disease.. The aim of the study is to analyze the efficacy of dual task training to improve functional gait performance in idiopathic Parkinson’s disease subjects. Design and setting: A randomized controlled study design was used to examine the differences in conventional therapeutic exercises and conventional therapeutic exercises with specific external cueing strategies given between two groups. Subjects: A sample of 10 subjects with idiopathic Parkinson’s disease was screened using Timed up and go test (TUG Test) and those who scored 24% less was taken for the study .the subjects were of both genders aged between 50-75 years of age with medically stable patients. They were divided into two groups of control and experimental group.the study was done in Masterskill College of nursing and health. Outcome Measurement: Functional gait performance will be measured using the timed up and Go (TUG) test with added motor and cognitive tasks, participants will be asked to walk as quickly as they safely can under all conditions and will be permitted to use their usual gait aid. Results: Data Analysis of the subjects after dual task training led to a greater improvement in functional walking capacity and step length. The average percentage of improvement in timed up and go test is 53%. Conclusion: According to this study Dual task training had improved step length and functional walking capacity in idiopathic Parkinson’s disease.
The technology supporting the analysis of human motion has advanced dramatically. Past decades of locomotion research have provided us with significant knowledge about the accuracy of tests performed, the understanding of the process of human locomotion, and how clinical testing can be used to evaluate medical disorders and affect their treatment. Gait analysis is now recognized as clinically useful and financially reimbursable for some medical conditions. Yet, the routine clinical use of gait analysis has seen very limited growth. The issue of its clinical value is related to many factors, including the applicability of existing technology to addressing clinical problems; the limited use of such tests to address a wide variety of medical disorders; the manner in which gait laboratories are organized, tests are performed, and reports generated; and the clinical understanding and expectations of laboratory results. Clinical use is most hampered by the length of time and costs required for performing a study and interpreting it. A “gait” report is lengthy, its data are not well understood, and it includes a clinical interpretation, all of which do not occur with other clinical tests. Current biotechnology research is seeking to address these problems by creating techniques to capture data rapidly, accurately, and efficiently, and to interpret such data by an assortment of modeling, statistical, wave interpretation, and artificial intelligence methodologies. The success of such efforts rests on both our technical abilities and communication between engineers and clinicians.
Gait analysis in laboratory animals studying coordinated movement and associa...InsideScientific
Gait analysis in lab animals is increasingly being recognized as a key feature in the research of disorders that affect human motor behavior. For example, gait disturbances are symptomatic of patients with Parkinson’s disease, muscular dystrophy and arthritis, but rarely has gait been studied in the animal surrogates. Other assays, such as grip strength, rotarod and activity fall short, both individually and collectively, in describing the convergence of strength, balance and coordination in enabling a subject to ambulate. In this webinar we therefore aim to present key concepts regarding how gait can be studied and its value as a research method for animal models of pain, CNS, neuromuscular and neurodegenerative disorders.
In this webinar sponsored by Mouse Specifics, Inc., Dr. Thomas Hampton provides an overview of essential parameters for studying gait in laboratory rodents. Topics include key aspects of coordinated movement [walking] such as stride, swing, stance and ataxia. He discusses how animals execute "stepping" via the convergence of motor and sensory inputs and will present a myriad of conditions that can affect walking along with how these conditions can be quantified for use as physiological markers of movement disorders.
Dr. Charles Meshul, Research Biologist and Professor at Veterans Hospital, Portland and Oregon Health & Sciences University, presents gait data obtained from his lab using a progressive animal model of Parkinson’s disease. His group has shown that weekly treatment with the neurotoxin, MPTP, for up to 4 weeks, results in a gradual loss of dopamine within the nigrostriatal pathway. He discusses how this unique model may or may not correlate to the extent of motor function tests available and will discuss the sensitivity of gait analysis in describing mice with Parkinson’s disease.
Dr. Carol Milligan, Professor of Neurobiology & Anatomy at Wake Forest School of Medicine, presents behavioral deficits that correlate with early pathology in the SOD1 mouse model of amyotrophic lateral sclerosis (ALS). As Dr. Milligan describes, one potential explanation for why preclinical studies in animal models have not translated positively to clinical trials may be insufficient understanding of when and where pathogenesis begins. Characterization of these early events and correlation to human disease is essential, however, for insight into disease onset, discovery of presymptomatic diagnostic disease markers, and identification of novel therapeutic targets. Dr. Milligan highlights early pathological changes identified in her lab and, importantly, analysis of mouse movement that has revealed deficits corresponding to early pathology.
The Challenges of Sarcopenia: Definition, Underlying Mechanisms, Intervention...InsideScientific
During this webinar, Drs. Peterson and Guralnik will discuss sarcopenia, the physiological mechanisms underlying the disease, and the current avenues of treatment and assessment that are being researched and developed for patients.
Sarcopenia is the age-related loss of muscle that causes decreased strength and functional limitations. Muscle loss occurs universally in people as we age, but some people lose muscle at an accelerated rate compared to others. While chronic disease can cause sarcopenia, it can also result from a sedentary lifestyle, hospitalizations and extended bed rest due to other conditions.
A gradual decline in muscle mass and strength begins around 30 years of age with this condition, and annual losses get larger throughout life. The self-reporting of functional difficulties to health care providers may give an indication that sarcopenia is present, but a more precise definition is needed for research and clinical use.
Efforts made in Europe and the US have used grip strength, gait speed and lean mass to define sarcopenia, but these definitions lead to large differences in prevalence rate and discordance in who is labelled as “sarcopenic”. To assess this condition, lean mass as measured by dual x-ray absorptiometry (DXA) may not accurately reflect actual muscle mass, but a new technique using dilution of deuterium-labelled creatine may prove to be superior in clinically diagnosing sarcopenia. Currently, a consensus has not been reached on the clinical outcome assessments that can be used by regulatory agencies to judge the effectiveness of drugs for sarcopenia.
A number of potential interventions are being explored to treat sarcopenia in older people, but no drugs are currently approved for this condition. The antidiabetic drug metformin shows promise in preventing many age-associated conditions, but appears to blunt the benefits of exercise on muscle. Senolytic drugs, which clear senescent cells, may improve muscle repair following injury preferentially in older individuals.
Abstract
Introduction: Sarcopenia is a progressive and generalized loss of skeletal muscle mass and strength associated with ageing. Regular exercise has been indicated to be the only strategy which consistently improves sarcopenia and physical function in elderly. The aims of this study are to review the mechanisms of sarcopenia and to evaluate the role of exercise in the elderly with sarcopenia and the current recommendations about the exercise interventions.
Discussion: Exercise significantly improve mobility, functionality, muscle mass, bone mineral density, balance and proprioception; thus, decreasing the risk of falls, increasing quality of life and reducing morbidity and mortality. Different types of exercise may be of interest in patients with sarcopenia: aerobic, progressive resistance, flexibility and balance training. Supervised or group exercise programs may be preferable for elders, with regard to both safety and compliance.
Conclusion: Sarcopenia is a strong predictor of disability, morbidity, and mortality in elderly. Anaerobic exercise seems to be the most important tool to prevent and treat sarcopenia.
Miguel JuncoReferences PathophysiologyBohannon, R. W. (1983). .docxendawalling
Miguel Junco
References Pathophysiology
Bohannon, R. W. (1983). Results of Resistance Exercise on a Patient with Amyotrophic Lateral Sclerosis. Phys. Ther, 63(6), 965–968. doi: 10.1093/ptj/63.6.965
Goodman, C. C., & Marshall, C. (2017). Pathology for the physical therapist assistant. Philadelphia: Saunders.
Jette, D. U., Slavin, M. D., Andres, P. L., & Munsat, T. L. (1999). The Relationship of Lower-Limb Muscle Force to Walking Ability in Patients with Amyotrophic Lateral Sclerosis. Phys Ther, 79(7), 672–681. doi: 10.1093/ptj/79.7.672
Martin, S., & Kessler, M. (2016). Neurologic interventions for physical therapy. St. Louis: Elsevier Saunders.
Bello-Haas, V. D., Kloos, A. D., & Mitsumoto, H. (1998). Physical Therapy for a Patient Through Six Stages of Amyotrophic Lateral Sclerosis. Phys. Ther, 78(12), 1312–1324. doi: 10.1093/ptj/78.12.1312
The Relationship of Lower-Limb
Muscle Force to Walking Ability in
Patients With Amyotrophic
Lateral Sclerosis
Background and Purpose. The purpose of this study was to determine
the level of muscle force associated with ability to walk in the
community without assistance, in the community with assistance, or at
home only in individuals with amyotrophic lateral sclerosis (ALS).
Subjects and Methods. Percentage of predicted maximal muscle force
(%PMF) of lower-extremity muscles was determined, and walking
ability was categorized in 118 patients with ALS during periodic visits to
the Neuromuscular Research Unit. Data were derived from consecu-
tive visits in which subjects demonstrated declines in walking ability.
Means for %PMF of each muscle group and a limb average were
calculated at each consecutive visit. Results. The mean lower-extremity
average %PMF was: (1) 54.01% (SD512.76%) for subjects who walked
independently in the community and 50.19% (SD514.38%) during
the next visit when these same subjects required assistance in the
community (difference53.82%, 95% confidence interval [CI]5
2.4525.19);(2) 37.52% (SD515.17%) during the last visit that subjects
walked with assistance in the community and 32.18% (SD513.83%)
during the next visit when they walked only at home (differ-
ence55.33%, 95% CI53.61–7.06); and (3) 19.12% (SD59.08%) dur-
ing the visit when subjects were last able to ambulate at home versus
13.70% (SD57.36%) when they became unable to walk (differ-
ence55.42%, 95% CI52.9727.96). Conclusion and Discussion. The
findings suggest there are required levels of lower-extremity muscle
force for various categories of walking ability. Variations in forces
within and between categories of walking ability, however, indicate the
complexity of this relationship. [Jette DU, Slavin MD, Andres PL,
Munsat TL. The relationship of lower-limb muscle force to walking
ability in patients with amyotrophic lateral sclerosis. Phys Ther.
1999;79:672– 681.]
Key Words: Gait; Muscle performance, lower extremity; Neuromuscular disorders, general.
672 Physical Therapy . Volume 79 . Number 7 . July 1999
Re
se
ar.
Miguel JuncoReferences PathophysiologyBohannon, R. W. (1983). .docxaltheaboyer
Miguel Junco
References Pathophysiology
Bohannon, R. W. (1983). Results of Resistance Exercise on a Patient with Amyotrophic Lateral Sclerosis. Phys. Ther, 63(6), 965–968. doi: 10.1093/ptj/63.6.965
Goodman, C. C., & Marshall, C. (2017). Pathology for the physical therapist assistant. Philadelphia: Saunders.
Jette, D. U., Slavin, M. D., Andres, P. L., & Munsat, T. L. (1999). The Relationship of Lower-Limb Muscle Force to Walking Ability in Patients with Amyotrophic Lateral Sclerosis. Phys Ther, 79(7), 672–681. doi: 10.1093/ptj/79.7.672
Martin, S., & Kessler, M. (2016). Neurologic interventions for physical therapy. St. Louis: Elsevier Saunders.
Bello-Haas, V. D., Kloos, A. D., & Mitsumoto, H. (1998). Physical Therapy for a Patient Through Six Stages of Amyotrophic Lateral Sclerosis. Phys. Ther, 78(12), 1312–1324. doi: 10.1093/ptj/78.12.1312
The Relationship of Lower-Limb
Muscle Force to Walking Ability in
Patients With Amyotrophic
Lateral Sclerosis
Background and Purpose. The purpose of this study was to determine
the level of muscle force associated with ability to walk in the
community without assistance, in the community with assistance, or at
home only in individuals with amyotrophic lateral sclerosis (ALS).
Subjects and Methods. Percentage of predicted maximal muscle force
(%PMF) of lower-extremity muscles was determined, and walking
ability was categorized in 118 patients with ALS during periodic visits to
the Neuromuscular Research Unit. Data were derived from consecu-
tive visits in which subjects demonstrated declines in walking ability.
Means for %PMF of each muscle group and a limb average were
calculated at each consecutive visit. Results. The mean lower-extremity
average %PMF was: (1) 54.01% (SD512.76%) for subjects who walked
independently in the community and 50.19% (SD514.38%) during
the next visit when these same subjects required assistance in the
community (difference53.82%, 95% confidence interval [CI]5
2.4525.19);(2) 37.52% (SD515.17%) during the last visit that subjects
walked with assistance in the community and 32.18% (SD513.83%)
during the next visit when they walked only at home (differ-
ence55.33%, 95% CI53.61–7.06); and (3) 19.12% (SD59.08%) dur-
ing the visit when subjects were last able to ambulate at home versus
13.70% (SD57.36%) when they became unable to walk (differ-
ence55.42%, 95% CI52.9727.96). Conclusion and Discussion. The
findings suggest there are required levels of lower-extremity muscle
force for various categories of walking ability. Variations in forces
within and between categories of walking ability, however, indicate the
complexity of this relationship. [Jette DU, Slavin MD, Andres PL,
Munsat TL. The relationship of lower-limb muscle force to walking
ability in patients with amyotrophic lateral sclerosis. Phys Ther.
1999;79:672– 681.]
Key Words: Gait; Muscle performance, lower extremity; Neuromuscular disorders, general.
672 Physical Therapy . Volume 79 . Number 7 . July 1999
Re
se
ar ...
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RESEARCH ARTICLE
Association between Physical Fitness and
Successful Aging in Taiwanese Older Adults
Pay-Shin Lin1,2☯‡*, Chih-Chin Hsieh1☯‡, Huey-Shinn Cheng3, Tsai-Jou Tseng1, Shin-
Chang Su1
1 Department of Physical Therapy & Graduate Institute of Rehabilitation Science, College of Medicine,
Chang Gung University, Taoyuan, Taiwan, 2 Health Aging Research Center, Chang Gung University &
Chang Gung Memorial Hospital, Taoyuan, Taiwan, 3 Internal & Geriatric Medicine, Chang Gung Memorial
Hospital, LinKou Branch, Taoyuan, Taiwan
☯ These authors contributed equally to this work.
‡ PSL and CCH are co-first authors on this work.
* [email protected]
Abstract
Population aging is escalating in numerous countries worldwide; among them is Taiwan,
which will soon become an aged society. Thus, aging successfully is an increasing concern.
One of the factors for achieving successful aging (SA) is maintaining high physical function.
The purpose of this study was to determine the physical fitness factors associated with SA
in Taiwanese older adults (OAs), because these factors are intervenable. Community-
dwelling OAs aged more than 65 years and residing in Northern Taiwan were recruited in
this study. They received a comprehensive geriatric assessment, which includes sociode-
mographic data, health conditions and behaviors, activities of daily living (ADL) and instru-
mental ADL (IADL) function, cognitive and depressive status, and quality of life. Physical
fitness tests included the grip strength (GS), 30-second sit-to-stand (30s STS), timed up-
and-go (TUG), functional reach (FR), one-leg standing, chair sit-and-reach, and reaction
time (drop ruler) tests as well as the 6-minute walk test (6MWT). SA status was defined as
follows: complete independence in performing ADL and IADL, satisfactory cognitive status
(Mini-Mental State Examination� 24), no depression (Geriatric Depression Scale < 5), and
favorable social function (SF subscale� 80 in SF-36). Adjusted multiple logistic regression
analyses were performed. Among the total recruited OAs (n = 378), 100 (26.5%) met the
aforementioned SA criteria. After adjustment for sociodemographic characteristics and
health condition and behaviors, some physical fitness tests, namely GS, 30s STS, 6MWT,
TUG, and FR tests, were significantly associated with SA individually, but not in the multi-
variate model. Among the physical fitness variables tested, cardiopulmonary endurance,
mobility, muscle strength, and balance were significantly associated with SA in Taiwanese
OAs. Early detection of deterioration in the identified functions and corresponding interven-
tion is essential to ensuring SA.
PLOS ONE | DOI:10.1371/journal.pone.0150389 March 10, 2016 1 / 12
OPEN ACCESS
Citation: Lin P-S, Hsieh C-C, Cheng H-S, Tseng T-J,
Su S-C (2016) Association between Physical Fitness
and Successful Aging in Taiwanese Older Adults.
PLoS ONE 11(3): e0150389. .
Comparison of Selected Physical Fitness Components between Bangladeshi and In...iosrjce
The aim of this study was to compare the selected physical fitness components between Bangladeshi
and Indian girls aged 7 to 9 years old. The study was conducted on 107 Indian girls and 104 Bangladeshi girls
for the comparison of selected physical fitness variables. The selected variables for the study were upper body
strength endurance (flex arm hang), agility (4x10 m. shuttle run) and cardiovascular endurance (Reduced
cooper test). T-test was used to find out the significant difference among different disciplines. It was concluded
that there was significant difference between Indian and Bangladeshi girls in strength endurance (upper body).
But the significance differences were not found on agility and cardiovascular endurance variables. Indian girls
have better agility and cardio respiratory endurance than Bangladeshi girls but Bangladeshi girls have better
upper body strength endurance than Indian girls.
Sub153105.pdf my article Outcome Measurement of Electrical Stimulation on Qua...jayanta Jayanta0074U
Outcome Measurement of Electrical Stimulation on
Quadriceps Muscles for Knee Osteoarthritis
Jayanta Nath
Abstract: Introduction: Outcome measurement is very essential part to assess efficacy of treatment intervention. The first objective
was to perform a review of all outcome measurement used in manangement of knee OA. Secondly to know if there was any difference
of outcome measurement of electrical stimulation on quadriceps muscle based on collected review article. Question: What were the
various outcome measurement used for assessment of knee osteoarthritis specially when used electrical stimulation? Design: Review of
literature. Participant: reviewer. Adults with osteoarthritis of the knee. Intervention: Electrical stimulation for quadriceps. Outcome
measure : VAS, WOMAC, dynamometer,MMT,EMG etc Development: Literature searches were made in these databases: Medline
(Ovid), Pedro, SCOPUS, PsycINFO, Web of knowledge, CINAHL (EBSCOHost), SportDicus (EBSCOHost), DOAJ, Cochrane,
EMBASE, Academic Search Complete (EBSCOHost), Fuente Académica (EBSCOHost), and MedicLatina (EBSCOHost). A
retrospective search of 13 years was used until February 2015. 33 records were selected based on the affinity with the subject of the
review and their internal validity according to the PEDro scale. Conclusions: WOMAC, VAS, were most commonly used outcome
measurement for OA knee. recommend further research on ES and outcome measurement.There were many outcome measure for knee
OA based on literature search .The review evidence suggest that VAS,WOMAC,were useful for assessing quality of management.Out of
all outcome measurement tool the WOMAC,PPT, EMG were most valid and reliable tool.
Similar to A Practical Measure of Balance, Gait, and Muscular Power in Older Adults: The Short Physical Performance Battery (20)