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Sarcopenic obesity is the co‐existence of obesity and sarcopenia in individuals aged 40–75 years. The Japanese Working Group on Sarcopenic Obesity has developed diagnostic criteria tailored for the Japanese population, considering their unique characteristics compared with European populations. Our algorithm consists of two steps: screening and diagnosis. The screening of obesity mandates using waist circumference and/or body mass index (BMI) based on national standards, while screening for sarcopenia involves the “finger ring test” in addition to the Asian Working Group for Sarcopenia 2019 criteria. The final diagnosis of sarcopenia involves handgrip strength for low muscle strength, the five‐times chair stand test for low physical function, and limb skeletal muscle mass (corrected for BMI) for low muscle mass. Obesity is assessed by visceral fat area or body fat percentage. Sarcopenic obesity is then categorized into Stage I, with muscle weakness/loss of function, loss of muscle mass, and obesity; or Stage II, which includes complications. Further clinical validation is needed to refine the consensus and age range. Geriatr Gerontol Int 2024; ••: ••–••. [ABSTRACT FROM AUTHOR]

Introduction: Sarcopenia is common in children after liver transplantation (LTx). Resistance training (RT) may be effective in combating sarcopenia. Objectives: The purpose of the study was to test the feasibility and impact of a 12‐week RT program on skeletal muscle mass (SMM), muscle strength, physical performance (PP), and child–parent perspectives about RT. Methods: Children (6–18 years) post‐LTx and healthy controls (HC) underwent progressive RT using resistance bands. SMM and adipose tissue (MRI: abdomen and thigh), muscle strength (handgrip, push‐ups, sit‐to‐stand), and PP (6‐minute walk test [6MWT], timed‐up‐and‐down‐stair test [TUDS]) were measured before and after 12‐weeks of RT. Results: Ten children post‐LTx (11.9 ± 3.5 years) and 13 HC (11.7 ± 3.9 years) participated. LTx children significantly increased abdominal SM‐index (+4.6% LTx vs. a −2.7% HC; p = 0.01) and decreased visceral adipose tissue‐index (−18% LTx vs. −0.8% HC; p = 0.04) compared to HC. No thigh SMI changes were noted. Significant increases in 6MWT distance (LTx; p = 0.04), number of push‐ups (p = 0.04), and greater reduction times for TUDS (−10.6% vs. +1.7%; p = 0.05) occurred after 12 weeks. Higher thigh muscle‐fat content was associated with worse physical performance. These results were impacted by adherence (≥75% vs. <75%) and family engagement. Conclusions: RT in children post‐LTx is feasible and effective. RT in children post‐LTx may alleviate adverse outcomes associated with sarcopenia. [ABSTRACT FROM AUTHOR]

Background: Emerging data suggest a spectrum of pulmonary complications from COVID‐19, ranging from dyspnea to difficult ventilator weaning and fibrotic lung damage. Prolonged hospitalization is known to significantly affect activity levels, impair muscle strength and reduce cardiopulmonary endurance. Objective: To assess the feasibility and safety of inpatient pulmonary rehabilitation (PR) and to explore effects on functional capacity, physical performance, fatigue levels, and functional status. Design: A prospective feasibility study. Setting: Inpatient unit of a tertiary care hospital. Participants: Twenty‐five hospitalized patients diagnosed with post‐COVID‐19 fibrosis referred for PR. Intervention: Individualized PR intervention including breathing exercises, positioning, strengthening, functional training, and ambulation twice a day for 6 days a week. Outcome Measures: One‐minute sit‐to‐stand test (STST), Short Physical Performance Battery (SPPB), Fatigue Assessment Scale (FAS), and Post‐COVID‐19 Functional Status Scale (PCFS). Results: Twenty‐five participants (19 males, 6 females) with a mean age of 54.2 ± 13.4 years were enrolled. Sixteen completed the two‐point assessment after undergoing in‐patient PR of mean duration 14.8 ± 9 days. PR led to a significant improvement in all functional outcomes that is, STST (from 7.1 ± 4.3 repetitions to 14.2 ± 2.1 repetitions, SPPB (from 5 ± 2.8 to 9.4 ± 1.5), FAS (from 33.3 ± 10.8 to 25.8 ± 4.7) at the p ≤.001, and PCFS (from 3.6 ± 0.9 to 2.9 ± 1.2, p ≤.05). Conclusion: Early initiation of PR for hospitalized patients with COVID‐19 fibrosis was safe, well tolerated, and feasible and may improve functional status. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to investigate the association between handgrip strength and suicidal ideation in representative samples of adults aged ≥50 years from six LMICs (China, Ghana, India, Mexico, Russia, and South Africa). Methods: Cross‐sectional, community‐based data from the World Health Organization's Study on Global Aging and Adult Health were analyzed. Handgrip strength quintiles by sex were created based on the average value of two handgrip measurements of the dominant hand. Self‐reported information on past 12‐month suicidal ideation was collected. Multivariable logistic regression analysis was conducted to assess associations. Results: Data on 34,129 individuals were analyzed [mean (SD) age 62.4 (16.0) years; age range 50–114 years; 52.1% females]. After adjustment for potential confounders, in the overall sample, compared to the handgrip strength quintile with the highest values [Quintile 1 (Q1)], Q2, Q3, Q4, and Q5 were associated with significant 2.15 (95% CI = 1.05–4.39), 2.78 (95% CI = 1.06–7.32), 3.53 (95% CI = 1.68–7.42), and 6.79 (95% CI = 2.80–16.48) times higher odds for suicidal ideation. Conclusions: Lower handgrip strength was significantly and dose‐dependently associated with higher odds for suicidal ideation in adults aged ≥50 years from LMICs. Future longitudinal studies are needed to understand the underlying mechanisms, and whether increasing general muscular strength and physical function may lead to reduction in suicidal ideation. [ABSTRACT FROM AUTHOR]

Background: Allogeneic hematopoietic stem cell transplantation (allo‐HSCT) is a potentially curative treatment for hematological malignancies. Several complications following allo‐HSCT, such as graft‐versus‐host disease, infection, and malnutrition, often cause physical dysfunction, and the assessment of physical function and evaluation of muscle mass are incompletely performed. Use of ultrasound (US) allows muscle mass measurement in patients with poor general conditions. In allo‐HSCT recipients, the correlation between physical function and muscle thickness, as measured by US, remains unclear. Objective: To clarify whether muscle thickness measured by US correlated with physical function in allo‐HSCT recipients. Design: A single‐center prospective cohort study. Setting: Hospital. Patients: Ninety‐two patients underwent allo‐HSCT at our hospital from April 2017 to March 2019. Interventions: Not applicable. Main Outcome Measure(s): Biceps and quadriceps muscle thickness measured by US, grip strength, isometric muscle strength (elbow flexion and knee extension), and 6‐minute walking test (6MWT) before allo‐HSCT and on days 30, 90, 180, 1 year, and 2 years after allo‐HSCT. The implementation rates of these assessments were also investigated. Results: Correlations were observed between biceps thickness and elbow flexion muscle strength/grip strength before allo‐HSCT, on days 30, 90, 180, 1 year, and 2 years after allo‐HSCT (r = 0.71/0.74, 0.73/0.72, 0.70/0.79, 0.67/0.75, 0.72/0.75, and 0.85/0.79, respectively, all p <.001). At the same time points, quadriceps thickness moderately correlated with knee extensor strength (r = 0.49, 0.50, 0.45, 0.64, 0.61, and 0.58, all p <.001). However, biceps and quadriceps thicknesses did not correlate with the 6MWT. The percentages of patients measured with US and 6MWT were 93.4% and 82.4% (p =.01) on day 30 and 97.5% and 87.8% (p =.02) on day 90, respectively. Conclusions: US assessment may be a useful alternative method for estimating muscle strength in fragile allo‐HSCT recipients, particularly when physical function assessment is difficult to quantify. [ABSTRACT FROM AUTHOR]

Objective: The aim of our study was to evaluate the physical performance, balance, gait and activities of daily living (ADL) of older individuals with long COVID syndrome (LCS). Methods: A total of 124 individuals (49% women) with a mean age of 71.8 ± 5.8 years were included in the study. Participants were divided into two groups, older individuals with LCS in the LCS group and older individuals who were not diagnosed with COVID‐19 in the CON (control) group. Physical performance of participants was evaluated with the Alusti Test, balance and gait assessment was evaluated with the Tinetti Balance and Gait Assessment (TBGA), and ADL were evaluated with the Barthel Index (BI). Results: In the evaluations between groups, the mean score of active muscular mobility of right and left upper extremities, transfer supine position to sitting, trunk in sitting position and standing, which are among the subparameters of the Alusti Test, were statistically significantly lower in LCS compared to CON (p <.05). TBGA total score and gait section mean score of TBGA were statistically significantly lower in LCS than in CON (p <.05). There was no significant difference between the groups in the balance section of the TBGA and the mean BI scores (p >.05). Conclusions: It was concluded that physical performance parameters related to active muscular mobility of the upper extremity, transfer supine position to sitting, trunk in sitting position and walking in LCS were negatively affected by the disease, but this did not affect the level of balance and independence in ADL. [ABSTRACT FROM AUTHOR]

Background: Walking slows with aging often leading to mobility disability. Mitochondrial energetics has been found to be associated with gait speed over short distances. Additionally, walking is a complex activity but few clinical factors that may be associated with walk time have been studied. Methods: We examined 879 participants ≥70 years and measured the time to walk 400 m. We tested the hypothesis that decreased mitochondrial energetics by respirometry in muscle biopsies and magnetic resonance spectroscopy in the thigh and is associated with longer time to walk 400 m. We also used cardiopulmonary exercise testing to assess the energetic costs of walking: maximum oxygen consumption (VO2peak) and energy cost–capacity (the ratio of VO2, at a slow speed to VO2peak). In addition, we tested the hypothesis that selected clinical factors would also be associated with 400‐m walk time. Results: Lower Max OXPHOS was associated with longer walk time, and the association was explained by the energetic costs of walking, leg power, and weight. Additionally, a multivariate model revealed that longer walk time was also significantly associated with lower VO2peak, greater cost–capacity ratio, weaker leg power, heavier weight, hip and knee stiffness, peripheral neuropathy, greater perceived exertion while walking slowly, greater physical fatigability, less moderate‐to‐vigorous exercise, less sedentary time, and anemia. Significant associations between age, sex, muscle mass, and peripheral artery disease with 400‐m walk time were explained by other clinical and physiologic factors. Conclusions: Lower mitochondrial energetics is associated with needing more time to walk 400 m. This supports the value of developing interventions to improve mitochondrial energetics. Additionally, doing more moderate‐to‐vigorous exercise, increasing leg power, reducing weight, treating hip and knee stiffness, and screening for and treating anemia may reduce the time required to walk 400 m and reduce the risk of mobility disability. [ABSTRACT FROM AUTHOR]

Objective: To determine the impact of occupational therapy (OT) on the self‐management of function, pain, fatigue, and lived experience for people living with rheumatoid arthritis (RA). Methods: Five databases and gray literature were searched up to June 30, 2022. Three reviewers screened titles and abstracts, with two independently extracting and assessing full texts using the Cochrane risk of bias (quantitative) and Critical Appraisal Skills Programme (qualitative) tools to assess study quality. Studies were categorized into four intervention types. Grading of Recommendations, Assessment, Development and Evaluations (GRADE) (quantitative) and GRADE‐ Confidence in Evidence from Reviews of Qualitative research (qualitative) were used to assess the quality of evidence for each intervention type. Results: Of 39 eligible papers, 29 were quantitative (n = 2,029), 4 qualitative (n = 50), and 6 mixed methods (n = 896). Good evidence supports patient education and behavior change programs for improving pain and function, particularly group sessions of joint protection education, but these do not translate to long‐term improvements for RA (>24 months). Comprehensive OT had mixed evidence (limited to home OT and an arthritis gloves program), whereas limited evidence was available for qualitative insights, splints and assistive devices, and self‐management for fatigue. Conclusion: Although patient education is promising for self‐managing RA, no strong evidence was found to support OT programs for self‐managing fatigue or patient experience and long‐term effectiveness. More research is required on lived experience, and the long‐term efficacy of self‐management approaches incorporating OT, particularly timing programs to meet the individual's conditional needs (i.e., early or established RA) to build on the few studies to date. [ABSTRACT FROM AUTHOR]

Aberrant autophagic activity is observed in osteoarthritic joints. Vitamin D was shown to alleviate not only osteoarthritis severity, but also autophagy process. However, the influence of vitamin D on autophagy in knee osteoarthritis (KOA) remains ambiguous. This study aimed to determine the effect of vitamin D2 on serum levels of autophagosome protein LC3A in patients with KOA and whether LC3A levels were correlated with serum 25‐hydroxyvitamin D (25(OH)D) and clinical outcomes of patients with KOA. A total of 165 patients with KOA and 25 healthy controls were recruited. Vitamin D2 (ergocalciferol) was administered to patients with KOA at a weekly dosage of 40,000 IU. Serum LC3A, knee pain and functional scores, muscle strength, physical performance, and biochemical parameters were examined before and after 6 months of vitamin D2 supplementation. Serum LC3A levels were significantly higher in patients with KOA than healthy controls. In patients with KOA, vitamin D2 supplementation significantly decreased serum LC3A levels. Furthermore, baseline levels of serum LC3A were significantly associated with radiographic severity, pain and functional scores, total cholesterol, hs‐CRP, IL‐6, protein carbonyl, and serum 25(OH)D. After adjusting for established confounders, independent relationships among serum LC3A and radiographic severity, pain and functional scores, total cholesterol, hs‐CRP, IL‐6, protein carbonyl, and serum 25(OH)D were also observed. Vitamin D2 supplementation was shown to not only decrease serum levels of LC3A, inflammatory markers, as well as oxidative stress, but also improve muscle strength and physical performance in patients with KOA. [ABSTRACT FROM AUTHOR]

Contemporary antiobesity medications (AOMs) are highly efficacious for the treatment of obesity and obesity‐related comorbidities. Given this effectiveness, lifestyle factors within the context of AOM treatments need to refocus and move away from efforts to enhance weight loss. Rather, lifestyle considerations should pivot to being complementary to the benefits realized with AOM treatment and be redirected to enhancing holistic patient health and well‐being. Physical activity is an important lifestyle behavior that contributes to many health benefits both in conjunction with, and in the absence of, weight loss. Physical activity improves cardiorespiratory fitness, muscle strength, and physical function. Physical activity may attenuate the loss of lean mass that is observed with AOM treatments and may enhance the quality and function of muscle. Physical activity is a key behavior for holistic health within this era of contemporary AOMs that warrants appropriate attention within the clinical care of patients. [ABSTRACT FROM AUTHOR]

Nervous system deterioration is a primary driver of age‐related motor impairment. The motor neurones, which act as the interface between the central nervous system and the muscles, play a crucial role in amplifying excitatory synaptic input to produce the desired motor neuronal firing output. For this, they utilise their ability to generate persistent (long‐lasting) depolarising currents that increase cell excitability, and both amplify and prolong the output activity of motor neurones for a given synaptic input. Modulation of these persistent inward currents (PICs) contributes to the motor neurones' capacities to attain the required firing frequencies and rapidly modulate them to competently complete most tasks. Thus, PICs are crucial for adequate movement generation. Impairments in intrinsic motor neurone properties can impact motor unit firing capacity, with convincing evidence indicating that the PIC contribution to motor neurone firing is reduced in older adults. Indeed, this could be an important mechanism underpinning the age‐related reductions in strength and physical function. Furthermore, resistance training has emerged as a promising intervention to counteract age‐associated PIC impairments, with changes in PICs being correlated with improvements in muscular strength and physical function after training. In this review, we present the current knowledge of the PIC magnitude decline during ageing and discuss whether reduced serotonergic and noradrenergic input onto the motor neurones, voltage‐gated calcium channel dysfunction or inhibitory input impairments are candidates that: (i) explain age‐related reductions in the PIC contribution to motor neurone firing and (ii) underpin the enhanced PIC contribution to motor neurone firing following resistance training in older adults. [ABSTRACT FROM AUTHOR]

Introduction: Boys with haemophilia (BwH) have improved health outcomes. Measures of physical function in haemophilia are not challenging or sensitive enough to reflect physical limitations or guide rehabilitation. To identify meaningful tests, we aimed to: evaluate the performance of BwH on two physical performance measures: iSTEP and 10 m‐ISWT; identify factors which predict performance and compare BwH to their unaffected peers. Methods: BwH completed both iSTEP and 10 m‐ISWT. Disease severity, age, BMI, HJHS, lower limb muscle torque, time spent in moderate to vigorous physical activity, sedentary time, were included as factors to predict performance. Results were compared to unaffected peers. Results: 43 boys median age 10 (10 mild/moderate, 26 severe, 7 inhibitors) were recruited. BwH were less likely to complete the iSTEP and performed less well on the 10 m‐ISWT than age matched peers. Ceiling effects were apparent for iSTEP, but not the 10 m‐ISWT test. Age was the only significant predictor for performance in the iSTEP, with older boys being more likely to achieve a higher level or complete the test. Greater age, lower BMI, milder disease severity and more time spent in MVPA all predicted better performance on the 10 m‐ISWT, with BMI and habitual physical activity a potential rehabilitation focus for underperforming individuals. HJHS and muscle strength did not predict performance on either test. Conclusion: Despite the space need to conduct the 10 m‐ISWT, it appears to be a superior performance measure than the iSTEP in BwH and provides clinically meaningful information, which can be interpreted using age‐specific normative reference equations. [ABSTRACT FROM AUTHOR]

Aim: To review the evidence for the effects of adapted bicycle riding on body structures and functions, activity, participation, and quality of life outcomes in children with disabilities, along with family‐level participation outcomes. Method: A systematic review with searches of nine electronic databases to identify studies involving participants with a developmental disability aged 4 to 18 years who used a dynamic adapted bicycle was completed in August 2021. Risk of bias was assessed based on individual study designs. A narrative synthesis integrated the findings of the included studies. Certainty of evidence was synthesized using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Results: Ten studies were included with 234 participants. Five studies reported outcomes at the body structures and functions level, ten reported activity‐level outcomes, two reported participation‐related outcomes, and none assessed quality of life or family participation in social and recreational activities. Interpretation: Adapted bicycle riding interventions may improve gross motor function, enhance lower‐limb muscle strength, and promote physical activity; however, certainty of evidence of effects was rated very low using GRADE. Further research is required to understand the impact of adapted bicycle riding on the participation outcomes of children and adolescents with disabilities and on family‐level participation in social and recreational activities. What this paper adds: Adapted bicycle riding interventions may improve motor functions and physical activity.Evidence about participation outcomes after adapted bicycle riding is limited.Research on adapted bicycle riding interventions in natural settings is needed. [ABSTRACT FROM AUTHOR]

Introduction: Peripheral artery disease (PAD) is commonly observed in patients undergoing hemodialysis. PAD impairs the vasculature and leads to pathophysiologic changes in the skeletal muscles, causing physical function impairment and physical inactivity in general. However, it is unclear whether PAD adversely affects physical function and physical activity in patients on hemodialysis. Methods: We performed a cross‐sectional study with a retrospective review of the data to determine whether PAD is associated with impaired physical function and physical activity in patients undergoing hemodialysis. The study population comprised 310 patients and 88 healthy subjects. PAD was diagnosed based on an ankle‐brachial index of <1.00 in patients on hemodialysis. Measurements of physical function included maximum walking speed, muscle strength in the lower extremities, and balance while standing. Findings: Of the 310 patients, 84 (27.1%) had PAD. When patients undergoing hemodialysis were divided into those without PAD and those with PAD, both groups had poorer physical function and physical activity than the healthy control subjects. After adjustments for potential confounders, it was found that patients on hemodialysis with PAD had slower walking speed, poorer standing balance, and less physical activity than those without PAD. However, there was no significant difference in lower extremity muscle strength between the two groups. Discussion: PAD diagnosed based on an ankle‐brachial index of <1.00 was independently associated with impaired physical function and reduced physical activity in patients undergoing hemodialysis. [ABSTRACT FROM AUTHOR]

Aim: Conventionally, the skeletal muscle area with computed tomography (CT) attenuation ranging from −29 to +150 Hounsfield unit (HU) divided by height squared (the conventional skeletal muscle index [SMI]) was used as an index of skeletal muscle mass. However, it includes fat‐infiltrated skeletal muscle, which is known to have poor function. This study aims to determine whether the low‐fat SMI, which uses skeletal muscle mass with CT attenuation ranging from +30 to +150 HU, or conventional SMI appropriately reflects the function of skeletal muscle. Methods: We retrospectively analyzed 120 patients with cirrhosis whose handgrip strength was measured. Among them, 48 patients underwent a physical performance assessment such as liver frailty index (LFI) and short physical performance battery (SPPB), and 80 underwent quality of life (QOL) assessment. The relationships between each SMI and handgrip strength, LFI, SPPB, and QOL were evaluated. Results: Low‐fat SMI was significantly correlated with handgrip strength (males, R = 0.393, p = 0.002; females, R = 0.423, p < 0.001) and LFI (males, R = −0.535, p = 0.035; females, R = −0.368, p = 0.039), whereas conventional SMI was not. When using low‐fat SMI, patients with low skeletal muscle mass had significantly low handgrip strength, LFI, SPPB, and physical and social‐related QOL score than those without. By contrast, no significant differences were found for any items when using conventional SMI. Conclusions: Low‐fat SMI is a good index of skeletal muscle mass that appropriately reflects skeletal muscle function. [ABSTRACT FROM AUTHOR]

Background: Physical dysfunction, including exercise intolerance, is a major factor for delayed societal reintegration for patients who underwent living‐donor liver transplantation (LDLT). However, what may contribute to early postoperative physical function is not well known. The purpose of this study is to elucidate the perioperative factors affecting early posttransplant exercise intolerance. Methods: 103 consecutive patients who underwent LDLT were enrolled, and 68 patients were retrospectively analyzed. We examined the relationship between postoperative exercise tolerance evaluated by a 6‐minute walking distance (6MWD) at discharge after surgery and demographic data, surgical information, preoperative physical function, clinical course, and the postoperative decline in physical function with univariate and multivariate analyses. Results: Almost all patients were discharged within 3 months after surgery. The postoperative 6MWD was 408 ± 94 m (68 [61–84]% of the predicted value), and patients who had a low %6MWD at discharge had significantly lower preoperative physical function than patients who had a high %6MWD at discharge (grip strength: 29.8 ± 8.9 kgf vs. 23.0 ± 8.8 kgf, P <.01, knee extensor strength: 138.9 ± 59.4 Nm vs. 95.2 ± 42.1 Nm, P <.01). Multivariate analysis revealed that preoperative knee extensor strength (standardized β = 0.35, P <.01) and first postoperative walking day (standardized β = −0.22, P =.04) were independently associated with the postoperative %6MWD. Conclusion: These results suggest that maintaining preoperative muscle strength and allowing for early postoperative mobilization might help to enhance the recovery of physical function and facilitate the patient's social reintegration after LDLT. [ABSTRACT FROM AUTHOR]

Objective: To predict the probability of a benefit from 2 contrasting exercise programs for women with a new diagnosis of mild knee osteoarthritis, and to estimate the short‐ and long‐term effects of aquatic resistance training (ART) and high‐impact aerobic land training (HLT) compared with a control. Methods: Original data sets from 2 previously conducted randomized controlled trials were combined and used in a Bayesian meta‐analysis. Group differences in multiple response variables were estimated. Variables included cardiorespiratory fitness, dynamic maximum leg muscle power, maximal isometric knee extension and flexion force, pain, other symptoms, and quality of life. The statistical model included a latent commitment variable for each female participant. Results: ART had a 55–71% probability of benefits in the outcome variables, and as the main effect, the intervention outperformed the control in cardiorespiratory fitness, with a probability of 71% immediately after the intervention period. HLT had a 46–63% probability of benefits after intervention with the outcome variables, but differently from ART; the positive effects of physical performance fade away during the follow‐up period. Overall, the differences between groups were small, and the variation in the predictions between individuals was high. Conclusion: Both interventions had benefits, but ART has a slightly higher probability of long‐term benefits on physical performance. Because of high individual variation and no clear advantage of one training method over the other, personal preferences should be considered in the selection of the exercise program to ensure highest commitment to training. [ABSTRACT FROM AUTHOR]

Muscle power training with emphasis on high‐velocity of concentric movement improves physical functionality in healthy older adults, and, maybe superior to traditional exercise programs. Power training may also be advantageous for patients with acute and chronic illnesses, as well as frail individuals. To determine the efficacy of power training compared with traditional resistance training on physical function outcomes in individuals diagnosed with frailty, acute illness or chronic disease. PubMed (MEDLINE), CINAHL, PEDro, Web of Science, and Google Scholar. (1) at least one study group receives muscle power training of randomized controlled trial (RCT) (2) study participants diagnosed as prefrail, frail or have an ongoing acute or chronic disease, condition or illness; (3) study participants over the age of 18; (4) publication in English language; (5) included physical function as the primary or secondary outcome measures. Two independent reviewers assessed articles for inclusion and graded the methodological quality using Cochrane Risk‐of‐Bias tool for RCTs. Fourteen RCTs met the inclusion criteria. In seven studies, muscle power training was more effective at improving physical function compared to control activities with a mean fixed effect size (ES) of 0.41 (p = 0.006; 95% CI 0.12 to 0.71). Power training and conventional resistance training had similar effectiveness in eight studies with a mean fixed ES of 0.10 (p = 0.061; 95% CI –0.01 to 0.40). Muscle power training is just as efficacious for improving physical function in individuals diagnosed with frailty and chronic disease when compared to traditional resistance training. The advantages of power training with reduced work per session may support power training as a preferential exercise modality for clinical populations. The findings should be interpreted with caution since generalizability is questioned due to the heterogeneity of patient populations enrolled and participants were relatively mobile at baseline. [ABSTRACT FROM AUTHOR]

Introduction: Although several outcomes are commonly measured to assess the effect of surgery for young people with cerebral palsy (CP), these are selected mainly by health professionals and researchers. Including the perspectives of a broader range of stakeholders is an essential step towards determining important outcomes for assessment. This qualitative study involves the development of a core outcome set (COS) for lower limb orthopaedic surgery for ambulant children with CP. Objective: This study aimed to identify outcomes that matter to children and young people with CP, their parents and healthcare professionals following lower limb orthopaedic surgery. Methods: Semi‐structured interviews were conducted with 10 healthcare professionals, 10 children and young people with CP and 8 parents. Interview data were analysed by content analysis supported by the International Classification of Functioning, Disability and Health (ICF‐CY) supplemented by thematic analysis. Findings: Thirty‐one outcomes were identified in total, which were linked to eleven second‐level ICF‐CY categories. There were differences between stakeholder groups in preferences and expectations from surgical outcomes. Healthcare professionals and children with their parents identified 31 and 25 outcomes, respectively. Health outcomes valued by participants were lower limb alignment and symmetry, flexibility and muscle strength, mental health, fatigue, pain, function in life, mobility, participation, being independent, quality of life and adverse events. Compared to previous published trials, 10 new outcomes were revealed by this study. Conclusion: The researchers identified outcomes that are important to all stakeholders following lower limb orthopaedic surgery for ambulant CP. Including these outcomes in future studies would promote patient‐centred care for children and young adults with CP. Findings will be used to inform an international Delphi survey and develop a COS in this field. Patient and Public Contribution: This study was informed by an advisory group including a young adult with CP and a parent of a child with CP. This group engaged in the design of the study and the information material to support the interview (information sheet and interview topic guide). [ABSTRACT FROM AUTHOR]

Background and purpose: Portable and wearable devices can monitor a number of physical performances and lately have been applied to patients with neuromuscular disorders (NMDs). Methods: We performed a systematic search of literature databases following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta‐Analyses) principles, including all studies reporting the use of technological devices for motor function assessment in NMDs from 2000 to 2021. We also summarized the evidence on measurement properties (validity, reliability, responsiveness) of the analyzed technological outcome measures. Results: One hundred studies fulfilled the selection criteria, most of them published in the past 10 years. We defined four categories that gathered similar technologies: gait analysis tools, for clinical assessment of pace and posture; continuous monitoring of physical activity with inertial sensors, which allow "unsupervised" activity assessment; upper limb evaluation tools, including Kinect‐based outcome measures to assess the reachable workspace; and new muscle strength assessment tools, such as Myotools. Inertial sensors have the evident advantage of being applied in the "in‐home" setting, which has become especially appealing during the COVID‐19 pandemic, although poor evidence from psychometric property assessment and results of the analyzed studies may limit their research application. Both Kinect‐based outcome measures and Myotools have already been validated in multicenter studies and different NMDs, showing excellent characteristics for application in clinical trials. Conclusions: This overview is intended to raise awareness on the potential of the different technology outcome measures in the neuromuscular field and to be an informative source for the design of future clinical trials, particularly in the era of telemedicine. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to explore nurses' perceptions of the factors associated with falls and of fall prevention strategies in acute care settings in Saudi Arabia. Design: This is a cross‐sectional, correlational, descriptive study. Methods: Data were collected from 102 nurses using a survey on the risk factors and prevention strategies of injurious falls. Results: We found that impaired balance and muscle strength, limited mobility, and an inability to follow safety instructions were reported as the top factors in falls. Multidisciplinary fall prevention strategies are effective in reducing the prevalence of falls. Nurses with higher levels of education had higher perceptions towards the risk factors of falls. Formal patient safety training, including fall prevention education programmes, were shown to reduce falls by making nurses more aware of fall risk factors and prevention strategies. The findings of this study can be used to inform managers about factors that may contribute to falls in acute care settings. [ABSTRACT FROM AUTHOR]

Objectives: To investigate whether masticatory movements in older patients with eating difficulties were associated with oral motor function, physical function, and appropriate food textures. Background: There are few reports on the association between masticatory movements and food textures in older patients with eating difficulties. Materials and Methods: This cross‐sectional study involved outpatients at a clinic that specialised in eating and swallowing rehabilitation. Masticatory movements were evaluated as normal or abnormal masticatory path patterns. Oral and physical functions were assessed in terms of oral and physical status, muscle strength and motor skills. The appropriate food texture was determined based on fibreoptic endoscopic evaluation of swallowing and a video fluoroscopic swallowing study. The associations between food texture and masticatory organ, muscle strength and motor skills were analysed. Results: A total of 126 outpatients (75 men and 51 women; mean age, 78.2 years; SD, 9.6 years) were included in the analysis. 68 participants (54.0%) showed abnormal masticatory movements. Masticatory movement was associated with masticatory performance (odds ratio [OR] = 0.99, 95% confidence interval [CI] = 0.98‐0.99), oral diadochokinesis (OR = 0.55, CI = 0.35‐0.86) and stepping test (OR = 0.92, CI = 0.86‐0.97). Masticatory movement (OR = 2.94, CI = 1.23‐7.01) and the number of natural teeth (OR = 0.94, CI = 0.89‐0.99) were associated with normal food. Conclusion: Masticatory movements in older patients with eating difficulties may be associated with appropriate food textures whilst being influenced by individual differences in systemic motor control. Masticatory movements may be as important as teeth to enjoy eating. [ABSTRACT FROM AUTHOR]

Background: Weakness and disuse of intrinsic foot muscles contributes to dysfunction in foot and toe alignment and sensory input, which may lead to instability and falls in older adults. The aim of this systematic review was to report the effects of intrinsic foot muscle strengthening (IFMS) interventions on functional mobility in adults aged ≥65 years. Methods: A systematic review was performed with searches from December 2019—February 2021 using MEDLINE, CINAHL, SPORTDiscus, Rehab and Sports Medicine Source, Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials. Additional sources were sought using reference scanning. Eligible sources analyzed adults aged ≥65 years (n = 1674) who were ambulatory, used a functional mobility outcome measure, and contained foot and ankle interventions that included IFMS. Literature studies regarding neurological, vestibular, cognitive, amputation, or post‐surgical conditions were excluded. Studies that did not specify intrinsic foot muscle involvement were excluded. Two authors extracted relevant studies and appraised them using the Physiotherapy Evidence Database (PEDro) scale. Results: A total of 1420 articles were screened for relevance, and 16 were extracted. Five additional sources were obtained through reference scanning. Nine articles were eligible for review. PEDro scores ranged from 3 to 7 (out of 10), indicating "fair" quality of evidence. Heterogeneity of methods and data did not allow for statistical comparison. Themes extracted from sources were types of intrinsic foot strengthening interventions and parameters; outcomes on falls, balance, functional mobility; and subjective reports regarding functional mobility. Conclusion: Evidence reviewed was of fair quality. IFMS interventions contributed to improvements in strength, balance, mobility, and possibly reduced fall risk. There was little effect on gait. Subjective reports indicate a possible mechanism for improved mobility may be from increased proprioception and sensation. [ABSTRACT FROM AUTHOR]

Background: Chronic low‐grade inflammation has been suggested as one of the key elements in the development of sarcopenia, but in contrast to disease‐related loss of muscle mass, the role of chronic low‐grade inflammation in age‐related (primary) sarcopenia is still not clear. The aim of this study was to investigate low‐grade inflammation in relation to age and the potential association between inflammatory biomarkers and body composition, muscle strength and physical performance in a healthy Danish cohort. Methods: There were 1160 generally healthy men and women (range: 22–93 years) included. Appendicular lean mass (ALM) and visceral fat normalized to height (kg/m2) was assessed by dual‐energy X‐ray absorptiometry (iDXA, GE Lunar). Muscle strength and physical performance were evaluated by handgrip strength (HGS), 30 s sit‐to‐stand performance, and maximal gait speed (GS). Systemic levels of TNF‐α, IL‐6, IL‐1β, IL‐4, IL‐13, and IFN‐γ were measured using multiplex bead‐based immunoassays (Bio‐Rad). hsCRP was assessed using latex particle‐enhanced immunoturbidimetric assays (Roche Diagnostics). Results: With age, ALM/h2, HGS, sit‐to‐stand performance and GS decreased, whereas visceral fat/h2 increased in both men and women (P < 0.05). Systemic levels of hsCRP, TNF‐α, IL‐4, and IFN‐γ increased with age in men and women (P < 0.05), while IL‐1β increased in women only (P < 0.01). Higher levels of hsCRP were associated with lower ALM/h2 in elderly (≥65 years) men and women (P < 0.001). Higher levels of hsCRP were associated with lower handgrip strength in elderly women (P < 0.05) whereas higher levels of hsCRP was not associated with lower HGS in elderly men (P = 0.056). Higher levels of hsCRP were associated with lower GS (P < 0.05), whereas IFN‐γ was positively associated with GS in elderly women (P < 0.05), but not elderly men. Visceral fat index was positively associated with hsCRP in elderly men and women (P < 0.001). Compared with elderly with normal HGS, elderly men and women with low HGS displayed higher levels of TNF‐α and hsCRP (P < 0.05). Conclusions: With age, systemic levels of hsCRP, TNF‐α, IL‐4, and IFN‐γ increased, with hsCRP and TNF‐α being especially elevated in more physically frail elderly supporting the association between low‐grade systemic inflammation and poor physical function. In contrast, only high levels of hsCRP were weakly associated with low muscle mass and positively associated with visceral fat and low physical function, suggesting that chronic low‐grade inflammation is not the main driver of age‐related loss of muscle mass as previously suggested. [ABSTRACT FROM AUTHOR]

Introduction: Chronic kidney disease (CKD) is characterized by adverse physical function. Mechanical muscle power describes the product of muscular force and velocity of contraction. In CKD, the role of mechanical muscle power is poorly understood and often overlooked as a target in rehabilitation. The aims of this study were to investigate the association of mechanical power with the ability to complete activities of daily living and physical performance. Method: Mechanical muscle power was estimated using the sit‐to‐stand‐5 test. Legs lean mass was derived using bioelectrical impedance analysis. Physical performance was assessed using gait speed and 'timed‐up‐and‐go' (TUAG) tests. Self‐reported activities of daily living (ADLs) were assessed via the Duke Activity Status Index. Balance and postural stability (postural sway and velocity) was assessed using a FysioMeter. Sex‐specific tertiles were used to determine low levels of power. Results: One hundred and two non‐dialysis CKD participants were included (age: 62.0 (±14.1) years, n = 49 males (48%), eGFR: 38.0 (±21.5) ml/min/1.73m2). The mean relative power was 3.1 (±1.5) W/kg in females and 3.3 (±1.3) W/kg in males. Low relative power was found in 34% of patients. Relative power was an independent predictor of ADLs (β =.413, p =.004), and TUAG (β = −.719, p <.001) and gait speed (β =.404, p =.003) performance. Skeletal muscle mass was not associated with any outcomes. Conclusion: Knowledge of the factors that mediate physical function impairment is crucial for developing effective interventions. Incorporation of power‐based training focusing primarily on movement velocity may present the best strategy for improving physical function in CKD, above those that focus on increasing muscle mass. SUMMARY AT A GLANCE: This study investigated the association of mechanical power with the ability to complete activities of daily living and physical performance in patients with ND‐CKD. Relative power was found to be an independent predictor of ADL, timed‐up‐and‐go and gait speed; however, skeletal muscle mass was not significantly associated with any outcomes. This study showed important aspects of management of patients with CKD for maintaining and improving of their quality of life. [ABSTRACT FROM AUTHOR]