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Background: This study examines the relationship between physical and mental function and frailty, independently and in conjunction with polypharmacy, among older adults. Methods: This cross-sectional study consisted of 368 participants aged ≥60 years. The participants were categorized into either robust or frail groups using Fried's frailty phenotype. Physical functions were assessed using grip strength, gait speed, Timed Up and Go (TUG), the Five Chair Sit to Stand Test (FCSST) and the Six-Minute Walk Test (SMWT). Mental functions were assessed using cognitive function and depression. Cognitive function was measured using Mini-Mental State Examination (MMSE). Depression was assessed with the Korean version of the Short Geriatric Depression Scale (SGDS). Results: The mean age of study population was 75.4 years. In this population, we identified 78.8% (n = 290) robust participants and 21.2% (n = 78) frail participants. The study examined frailty status (frail vs. non-frail) and frailty with and without polypharmacy using multivariate logistic regressions, adjusting for age and sex. In the logistic regression model estimating the risk of frailty, after adjustments for age, sex, BMI, and number of medications, individuals with low SMWT showed a significantly increased risk of frailty, with an odds ratio (OR) of 8.66 and a 95% confidence interval (CI) of 4.55–16.48. Additionally, global cognitive function was associated with a 1.97-fold increase in frailty risk (95% CI: 1.02–3.67). Moreover, in models adjusted for age, sex, and BMI to assess frailty risk linked to polypharmacy, the TUG, SMWT, and SGDS all showed increased risks, with ORs of 3.65 (95% CI: 1.07–12.47), 5.06 (95% CI: 1.40–18.32), and 5.71 (95% CI: 1.79–18.18), respectively. Conclusions: Physical function (SMWT, FCSST, TUG) and mental function (depression, cognition) were associated with frailty. By comprehensively examining these factors, we will gain valuable insights into frailty and enable more precise strategies for intervention and prevention. [ABSTRACT FROM AUTHOR]

Background: There is limited evidence on the effects of aerobic and resistance training exercise interventions to improve physical function and patient-reported outcomes prior to autologous and allogeneic hematopoietic stem cell transplant (HSCT). IMPROVE-BMT was a single-site, pilot randomized controlled trial investigating the feasibility, acceptability, and safety of a pragmatic resistance training exercise program prior to HSCT compared to usual HSCT care. Secondary aims included differences in physical function between the exercise group (EX) and usual care control group (UC). Methods: Outcome measurements were assessed: prior to HSCT, on/around day of HSCT admission, +30 days post-HSCT, and +100 days post-HSCT. The exercise intervention was a home-based exercise program that incorporated resistance-band and bodyweight exercises. Results: Acceptability among participants was 83%; exercise adherence averaged at 92%; and there were zero exercise-related adverse or serious adverse events. The average pre-transplant exercise phase was 6.28 weeks (2.71–18.29 weeks). EX (n = 36) demonstrated larger increases in the six-minute walk test distance, short physical performance battery scores, and 30-s chair stands compared to UC (n = 38) and demonstrated significant within-group improvements for the six-minute walk test, the short physical performance battery, the 30-s chair stands, and the timed up-and-go test. Conclusions: IMPROVE-BMT demonstrates that pragmatic exercise is highly feasible for HSCT recipients and can potentially lead to enhanced recovery that may not be achievable in non-exercisers. [ABSTRACT FROM AUTHOR]

Background: Older nursing home residents are at a greater risk of falling due to frailty. Exercise is effective at hampering frailty and related adverse events, including falls. Objectives: Our purpose was to evaluate the effect of a 12-week moderate-intensity multicomponent exercise programme on the number of falls and physical functioning among older nursing home residents. Also, we examined the association between the number of falls and demographics as well as physical and cognitive baseline data. Methods: The study protocol was registered on clinicaltrials.gov with the following identifier: NCT05835297. Older adults aged 65 years and over were recruited from a nursing home, and eligible and consenting residents were randomly allocated to two parallel groups: the intervention group, which performed a multicomponent exercise programme composed of strength, balance, and aerobic training (n = 12), and the control group, which received usual care (n = 12). Outcomes included falls, and measures of strength, balance, and mobility. Results: We had high adherence to exercise sessions, and no adverse events were recorded. We observed a non-significant reduction in falls (p = 0.34) and a significant improvement in Short Physical Performance Battery (p = 0.003) after the exercise programme. Falls were associated with being female and having diminished physical or cognitive function. Conclusions: Multicomponent exercise programmes should be implemented regularly in nursing homes for their effectiveness. Future studies with bigger samples, including participants with worse physical and cognitive impairments, as well as follow-up periods are required. [ABSTRACT FROM AUTHOR]

(1) Background: Long COVID syndrome (LCS) is a heterogeneous long-standing condition following COVID-19 infection. Treatment options are limited to symptomatic measures, and no specific medication has been established. Hyperbaric oxygenation (HBO) has been found to have a positive impact on the treatment of COVID-19 infection. This study evaluates both the feasibility and outcome of supportive HBO in patients with LCS. (2) Methods: Within 17 months, 70 patients with proven LCS were prospectively included. Each patient underwent a cycle of 10 subsequent HBO treatment sessions administered for 75 min at 2.2 atmospheres. Evaluation of the patients was performed before the first and after the last HBO session and 3 months afterwards. Statistical evaluation was based on an intention-to-treat analysis using Fisher's exact test and Student's t-test for paired samples. (3) Results: In total, 59 patients (33 females, 26 males; mean age: 43.9 years; range: 23–74 years; median: 45.0) were evaluable. After HBO, a statistically significant improvement of physical functioning (p < 0.001), physical role (p = 0.01), energy (p < 0.001), emotional well-being (p < 0.001), social functioning (p < 0.001), pain (p = 0.01) and reduced limitation of activities (p < 0.001) was confirmed. (4) Conclusions: Physical functioning and both the physical and emotional role improved significantly and sustainably, suggesting HBO as a promising supportive therapeutic tool for the treatment of LCS. [ABSTRACT FROM AUTHOR]

The purpose of this study is to examine how physical function, physical activity, and sleep are related to depressive symptoms in older adults using a nonlinear model. The participants were 283 Korean older adults aged 65 and older who met the study inclusion criteria. Depressive symptoms were measured using the shortened version of the Geriatric Depression Scale in Korean (SGDS-K). Physical activity and sleep time were objectively quantified by continuously monitoring participants over 20 consecutive days using a triaxial accelerometer. Physical function was evaluated using five distinct measurements: grip strength, gait speed, the Timed Up and Go Test (TUG), the Six-Minute Walk Test (SMWT), and the Five Times Sit to Stand Test (FTSST). The SMWT, gait speed, and MVPA exhibited a nonlinear relationship with depressive symptoms. However, other physical functions showed linear relationships. Also, sleep time showed a U-shaped trend starting at approximately 390 min. After adjusting for age, sex, drinking, and smoking in the logistic regression model, SMWT, MVPA, and sleep time were significantly associated with depressive symptoms. The outcomes highlight the importance of considering multiple factors in understanding depression among the elderly, particularly the intricate interactions between these elements and biological rhythms. [ABSTRACT FROM AUTHOR]

Background: Assessment of physical and respiratory function in the intensive care unit (ICU) is useful for developing an individualized treatment plan and evaluating patient progress. There is a need for measurement tools that are culturally adapted, reliable and easy to use. The Chelsea Critical Care Physical Assessment Tool (CPAx) is a valid measurement tool with strong psychometric properties for the intensive care population. This study aims to translate, adapt and test face validity and inter-rater reliability of the Norwegian version of CPAx (CPAx-NOR) for use in critically ill adult patients receiving prolonged mechanical ventilation. Method: CPAx-NOR was forward backward translated, culturally adapted and tested by experts and patients for face validity. Thereafter tested by 10 physiotherapists in five hospitals for inter-rater reliability. Results: The experts and pilot testers reached consensus on the translation and face validity. Patients were tested at time point A (n = 57) and at time point B (n = 53). The reliability of CPAx-NOR at "A" was 0.990 (0.983–0.994) and at "B" 0.994 (0.990–0.997). Based on A+B combined and adjusted, the ICC was 0.990 (95% CI 0.996–0.998). Standard error of measurement (SEM) was 0.68 and the minimal detectable change (MDC) was 1.89. The Bland–Altman plot showed low bias and no sign of heteroscedasticity. CPAx-NOR changed with a mean score of 14.9, and showed a moderate floor effect at the start of physiotherapy and low ceiling effects at discharge. Conclusion: CPAx-NOR demonstrated good face validity and excellent inter-rater reliability. It can be used as an assessment tool for physical function in critically ill adults receiving prolonged mechanical ventilation in Norway. [ABSTRACT FROM AUTHOR]

Post-COVID-19 syndrome (PCS) has been described as 'the pandemic after the pandemic' with more than 65 million people worldwide being affected. The enormous range of symptoms makes both diagnosis complex and treatment difficult. In a post-COVID rehabilitation outpatient clinic, 184 patients, mostly non-hospitalized, received a comprehensive, interdisciplinary diagnostic assessment with fixed follow-up appointments. At baseline, three in four patients reported more than 10 symptoms, the most frequent symptoms were fatigue (84.9%), decreased physical capacity (83.0%), tiredness (81.1%), poor concentration (73.6%), sleeping problems (66.7%) and shortness of breath (67.3%). Abnormalities were found in the mean values of scores for fatigue (FAS = 34.3), cognition (MoCA = 25.5), psychological alterations (anxiety, depression, post-traumatic stress disorder), limitation of lung function (CAT) and severity scores for PCS (PCFS, MCRS). Clinical abnormalities were found in elevated values of heart rate, breathing rate at rest, blood pressure and NT-proBNP levels. As the frequency of the described symptoms decreases only slowly but most often significantly over the course, it is important to monitor the patients over a longer period of time. Many of them suffer from an immense symptom burden, often without pre-existing clinical correlates. Our results show a clear association with objectifiable assessments and tests as well as pronounced symptoms. [ABSTRACT FROM AUTHOR]

(1) Background: To improve existing rehabilitation technologies, we conducted a systematic review and meta-analysis to identify the effect size of home-based rehabilitation using robotic, virtual reality, and game devices on physical function for stroke survivors. (2) Methods: Embase, PubMed, Cochrane Library, ProQuest, and CINAHL were used to search the randomized controlled trials that applied technologies via home-based rehabilitation, such as virtual reality, robot-assisted devices, and games. The effect size (Hedges's g) of technology type and affected limb on physical function were calculated. (3) Results: Ten studies were included. The effect size of home-based rehabilitation in virtual reality had the greatest value (Hedges's g, 0.850; 95% CI, 0.314–1.385), followed by robot-assisted devices (Hedges's g, 0.120; 95% CI, 0.003–0.017) and games (Hedges's g, −0.162; 95% CI, −0.036 to −0.534). The effect size was larger in the upper limbs (Hedges's g, 0.287; 95% CI, 0.128–0.447) than in the lower limbs (Hedges's g, −0.113; 95% CI, −0.547 to 0.321). (4) Conclusions: Virtual reality home rehabilitation was highly effective for physical function compared to other rehabilitation technologies. Interventions that consisted of a pre-structured and tailored program applied to the upper limbs were effective for physical function and psychological outcomes. [ABSTRACT FROM AUTHOR]

The use of sodium-glucose cotransporter 2 (SGLT2) inhibitors in patients with type 2 diabetes mellitus (T2DM) has been associated with decreased skeletal muscle mass but remains unclear in patients with cardiovascular disease (CVD) undergoing comprehensive outpatient cardiac rehabilitation (CR). Therefore, this study investigates the effect of SGLT2 inhibitors on the outcomes of patients with CVD and T2DM undergoing comprehensive outpatient CR. The study included 402 patients with CVD and T2DM who participated in comprehensive outpatient CR. Physical functions (grip strength, maximal quadriceps isometric strength, usual gait speed, and 6-minute walking distance) were measured at discharge as baseline and 5 months thereafter, and the association between physical functions and SGLT2 inhibitor use was reviewed. Physical functions improved regardless of SGLT2 inhibitor use. Multiple regression analysis showed that SGLT2 inhibitor use was not associated with improvement or decline in physical functions (p ≥ 0.05). The use of SGLT2 inhibitors in patients with CVD and T2DM undergoing outpatient CR did not impair improvement in physical functions. [ABSTRACT FROM AUTHOR]

Uncertainty remains regarding the benefit of hip replacement in older adults in the context of age-related decline in physical function. This study aimed to examine the effect of hip replacement on functional outcomes and identify factors associated with clinically important improvement in physical function postoperatively in community-dwelling older adults. This cohort study was performed within the ASPREE trial, with 698 participants receiving hip replacement and 677 age- and sex-matched controls without knee or hip replacement during the trial drawn from 16,703 Australian participants aged ≥70 years. Health status (physical and mental component summary [PCS and MCS]) was assessed annually using the SF-12. Participants receiving hip replacement had significantly lower pre- and post-replacement PCS scores compared with controls (p < 0.0001). There was significant improvement in PCS score following hip replacement (mean change 4.9, 95%CI 4.0–5.7) but no change in controls (0.01, 95%CI −0.7–0.7). Following hip replacement, 46.7% of participants experienced clinically important improvement in PCS score, while 15.5% experienced worsened PCS score. Participants experiencing improved postoperative PCS score had significantly lower PCS and higher MCS scores preoperatively. The degree of preoperative physical function impairment was a significant indicator of older people most likely to benefit from hip replacement surgery. [ABSTRACT FROM AUTHOR]

It is believed that patients with acute coronary syndrome (ACS) are at an increased risk of nonalcoholic fatty liver disease (NAFLD), which can lead to sarcopenia and physical dysfunction. However, the relationship between metabolic dysfunction-associated fatty liver disease (MAFLD) and physical dysfunction and prognosis remains unclear. We investigated the prevalence of MAFLD in patients with ACS to assess the relationship between MAFLD and muscle strength, walking speed, and 6-min walking distance (6 MWD). We reviewed patients with ACS who were assessed for hepatic steatosis using the fatty liver index, and the results were further assessed to determine the presence of MAFLD. Among 479 enrolled hospitalized patients, MAFLD was identified in 234 (48.9%) patients. Multiple regression analysis revealed that MAFLD was independently associated with lower leg strength, gait speed, and 6 MWD (leg strength, p = 0.020; gait speed, p = 0.003 and 6 MWD, p = 0.011). Furthermore, in multivariate Poisson regression models after adjustment for clinical confounding factors, combined MAFLD and reduced physical functions were significantly associated with a higher incidence of clinical events. MAFLD is common in hospitalized patients with ACS and is associated with impaired physical function. Also, the coexistence of MAFLD and lower physical function predict the incidence of clinical events in patients with ACS. [ABSTRACT FROM AUTHOR]

The prevalence of physical functioning limitations is positively correlated with age in both men and women. However, whether the appearance of deterioration differs depending on physical function and sex remains unclear. This study aimed to clarify the modes of age-related changes in physical function and sex differences in middle-aged and older adults. This study comprised 124 (46 men and 78 women) healthy adults aged 30 years or older and examined gender differences in physical function. The results of this study showed that one-leg standing time had the highest rate of age-related decline in both men and women, followed by knee extension strength, skeletal muscle mass, the 5 m walking test, and the timed up and go test. The sex-specific points showed a high rate of decline in trunk forward bending in men and a high rate of decline in forced expiratory volume (1 s) and gradual rate of decline in the bone area ratio in women. After middle age, it is desirable to start monitoring and training balance, muscle function, and walking. Men require early intervention for flexibility, and women require early intervention for respiratory function and continued intervention for bone mineral density. [ABSTRACT FROM AUTHOR]