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BACKGROUND: Lower urinary tract symptoms (LUTS) and mobility limitations are bidirectionally associated among older adults, but the role of skeletal muscle remains unknown. We evaluated cross-sectional associations of muscle health and physical performance with LUTS. METHODS: We used data from 377 women and 264 men aged >70 years in the Study of Muscle, Mobility and Aging (SOMMA). LUTS and urinary bother were assessed using the LURN Symptom Index-10 (SI-10; higher = worse symptoms). Muscle mass and volume were assessed using D3-creatine dilution (D3Cr) and magnetic resonance imaging. Grip strength and peak leg power assessed upper/lower extremity physical performance. 400-m walk, Short Physical Performance Battery (SPPB), and Four Square Step Test (FSST) assessed global physical performance. Mobility Assessment Tool-short form (MAT-sf) assessed self-reported mobility. We calculated Spearman correlation coefficients adjusted for age, body mass index, multimorbidity, and polypharmacy, chi-square tests, and Fishers Z-test to compare correlations. RESULTS: Among women, LURN SI-10 total scores were inversely correlated with FSST (rs = 0.11, p = .045), grip strength (rs = -0.15, p = .006), and MAT-sf (rs = -0.18, p = .001), but not other muscle and physical performance measures in multivariable models. LURN SI-10 was not associated with any of these measures among men. Forty-four percent of women in the lowest tertile of 400-m walk speed versus 24% in the highest tertile reported they were at least somewhat bothered by urinary symptoms (p

INTRODUCTION: Frailty and low physical performance are modifiable factors and, therefore, targets for interventions aimed at delaying driving cessation (DC). The objective was to determine the impact of frailty and physical performance on DC. METHODS: Multisite prospective cohort of older drivers. The key inclusion criteria are as follows: active driver age 65-79 years, possessing a valid drivers license, without significant cognitive impairment, and driving a 1996 car or a newer model car. Of the 2,990 enrolled participants, 2,986 (99.9%) had at least one frailty or Short Physical Performance Battery (SPPB) measure and were included in this study. In total, 42% of participants were aged 65-69 years, 86% were non-Hispanic white, 53% were female, 63% were married, and 41% had a high degree of education. The Fried Frailty Phenotype and the Expanded Short Physical Performance Battery (SPPB) from the National Health and Aging Trends Study were utilized. At each annual visit, DC was assessed by the participant notifying the study team or self-reporting after no driving activity for at least 30 days, verified via GPS. Cox proportional hazard models, including time-varying covariates, were used to examine the impact of the SPPB and frailty scores on time to DC. This assessment included examining interactions by sex. RESULTS: Seventy-three participants (2.4%) stopped driving by the end of year 5. Among women with a fair SPPB score, the adjusted hazard ratio (HR) of DC was 0.26 (95% confidence interval (CI) 0.10-0.65) compared to those with a poor SPPB score. For those with a good SPPB score, the adjusted HR of DC had a p-value of

Aim: This study examined the association of low handgrip strength (HGS) for falls in middle-aged adults and older adults every half-decade of life. Methods: This cross-sectional study was conducted using the public data from the first wave of the Brazilian Longitudinal Study of Aging (ELSI-Brazil). The participants were allocated into seven age groups 50–54, 55–59, 60–64, 65–69, 70–74, 75–79, and ≥ 80 years. Binary logistic regression analysis was performed to identify the odds ratio (OR) of low HGS to the falls regardless of confounding variables such as sex, balance, gait speed, and total number of health conditions. Results: A total of 8,112 participants aged 50–105 years (median = 62.0 years): 3,490 males (median = 60.0 years) and 4,622 females (median = 63.0 years) attended the study. Altogether, 21.5% of participants experienced at least one fall. HGS gradually decreases over each half-decade of life. In addition, low HGS presented a significative OR (p < 0.05) for falls for age groups, until 80 s, even when considering confounding variables. Conclusions: Low HGS is associated with falls in middle-aged adults over their 50 s and remained a strong measure of falls across each subsequent half-decade of life, until 80 s. [ABSTRACT FROM AUTHOR]

Background/Objectives: This study aimed to compare the effects of Xbox Kinect Sports (XKS) regarding Nintendo Switch Sports (NSS) and an inactive control group (CG) on body composition (body fat percentage, BFP; and fat-free mass) and physical performance (maximal isometric handgrip strength, MIHS; 30-s chair stand, 30-S; timed up-and-go, TUG; sit-and-reach; and 2-min step) in physically inactive older females. Methods: A randomized controlled trial study was conducted with three parallel groups: XKS (n = 13), NSS (n = 14), and CG (n = 16) considering three weekly 60-min sessions for 12 weeks with pre- and post-assessments. Results: A two-factor mixed analysis of variance (ANOVA) model with repeated measures was performed to measure the time × group effect. Multiple comparisons revealed significant differences in BFP (F(2,18) = 6.12; p = 0.005; ηp2 = 0.226, large effect), 30-S (F(2,18) = 20.7; p = 0.000; ηp2 = 0.496, large effect), TUG (F(2,18) = 10.0; p = 0.000; ηp2 = 0.323, large effect), sit-and-reach (F(2,18) = 37.3; p = 0.000; ηp2 = 0.640, large effect), and 2-min step (F(2,18) = 9.85; p = 0.000; ηp2 = 0.319, large effect) in favor of XKS regarding NSS and CG. The intragroup results only present in XKS a significant decrease in BFP (p = 0.02; d = 0.98) and significant improvements in the 30-S (p = 0.000; d = 1.88), TUG (p < 0.01; d = 2.00), sit-and-reach (p = 0.003; d = 2.58), and 2-min step (p = 0.004; d = 1.05). Conclusions: training using XKS significantly decreases BFP and improves 30-S, TUG, sit-and-reach, and 2-min step in physically inactive older females. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to assess the impact of a Tai Chi exercise program (TCEP) on pain, spinal flexibility, muscle strength, stability and balance, functional status, and quality of life (QoL) among home-dwelling patients with osteoarthritis (OA) or inflammatory arthritis (iA). Patients and methods: Between October 2018 and April 2019, a total of 28 participants (4 males, 24 females; median age: 62 years; range, 34 to 79 years) who completed the training program participating in at least 18 sessions were included. The TCEP consisted of 50 sessions for 60 min twice a week. The average attendance rate was high (78%, 39 sessions). Results: Chest mobility (breathing index, p<0.001), sagittal mobility of cervical (p<0.001), thoracic (p=0.009), and lumbar spine (Schober's test, p<0.001) improved significantly in participants with OA and iA. The improvement in functional status was significant only in participants with OA (Lequesne index, p=0.014). Although the change in Lequesne index was statistically significant, the median value remained in the range of severe disability and the change did not reach the minimal clinically important difference. Although the trends were positive, the changes in pain (Visual Analog Scale pain, p=0.599), stability and balance (functional reach test, p=0.341), muscular strength (wall sit test, p=0.069), and health-related QoL (15D, p=0.065) were non-significant in participants with OA and iA. Conclusion: Our study results suggest that a 25-week TCEP is safe and can improve chest and spinal mobility in home-dwelling individuals with OA or iA. [ABSTRACT FROM AUTHOR]

Abstract Aim This study examined the association of low handgrip strength (HGS) for falls in middle-aged adults and older adults every half-decade of life. Methods This cross-sectional study was conducted using the public data from the first wave of the Brazilian Longitudinal Study of Aging (ELSI-Brazil). The participants were allocated into seven age groups 50–54, 55–59, 60–64, 65–69, 70–74, 75–79, and ≥ 80 years. Binary logistic regression analysis was performed to identify the odds ratio (OR) of low HGS to the falls regardless of confounding variables such as sex, balance, gait speed, and total number of health conditions. Results A total of 8,112 participants aged 50–105 years (median = 62.0 years): 3,490 males (median = 60.0 years) and 4,622 females (median = 63.0 years) attended the study. Altogether, 21.5% of participants experienced at least one fall. HGS gradually decreases over each half-decade of life. In addition, low HGS presented a significative OR (p

Abstract Background Regaining walking ability is a key target in geriatric rehabilitation. This study evaluated the prevalence of walking ability at (pre‐)admission and related clinical characteristics in a cohort of geriatric rehabilitation inpatients; in inpatients without walking ability, feasibility and effectiveness of progressive resistance exercise training (PRT) were assessed. Methods Inpatients within RESORT, an observational, longitudinal cohort of geriatric rehabilitation inpatients, were stratified in those with and without ability to walk independently (defined by Functional Ambulation Classification (FAC) score ≤ 2) at admission; further subdivision was performed by pre‐admission walking ability. Clinical characteristics at admission, length of stay, and changes in physical and functional performance throughout admission were compared depending on (pre‐)admission walking ability. Feasibility (relative number of PRT sessions given and dropout rate) and effectiveness [change in Short Physical Performance Battery, FAC, independence in (instrumental) activities of daily living (ADL/IADL)] of PRT (n = 11) in a subset of inpatients without ability to walk independently at admission (able to walk pre‐admission) were investigated compared with usual care (n = 11) (LIFT‐UP study). Results Out of 710 inpatients (median age 83.5 years; 58.0% female), 52.2% were not able to walk independently at admission, and 7.6% were not able to walk pre‐admission. Inpatients who were not able to walk independently at admission, had a longer length of stay, higher prevalence of cognitive impairment and frailty and malnutrition risk scores, and a lower improvement in independence in (I)ADL compared with inpatients who were able to walk at both admission and pre‐admission. In LIFT‐UP, the relative median number of PRT sessions given compared with the protocol (twice per weekday) was 11 out of 44. There were no dropouts. PRT improved FAC (P = 0.028) and ADL (P = 0.034) compared with usual care. Conclusions High prevalence of inpatients who are not able to walk independently and its negative impact on independence in (I)ADL during geriatric rehabilitation highlights the importance of tailored interventions such as PRT, which resulted in improvement in FAC and ADL.

Background Cognitive dysfunction is frequently seen in multiple sclerosis (MS). However, there are conflicting findings regarding the factors it is associated with.

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Abstract Air Force pilots and some athletes (e.g., in sledding sports) are frequently exposed to high G-forces. High-intensity physical activity is essential to withstand gravitational acceleration, and morphological symmetry and functional movement are directly related to injury in those who perform these activities. However, the relationship between G-endurance and physical imbalance and the effect on physical performance is poorly understood. This study aimed to analyze the physical performance of those exposed to a high load of G-tolerance and who performed high-intensity physical activity. A total of 363 male cadets from the Korean Air Force Academy underwent functional movement screen tests, anatomical structure measurements, G-tests (fourth grade), and body composition and physical fitness tests. Participants were classified into the G-test-pass and -fail groups depending on the G-test results. The pass group showed significantly different bilateral imbalance in active straight leg raises (p

Abstract Background Maintaining good functional ability is a key component of healthy ageing and a basic requirement for carrying out activities of daily living, staying independent, and delaying admission to a nursing home. Even though women have a higher life expectancy and slower age-related muscle mass loss than men, they often show a higher prevalence of limitations in physical functioning. However, the reasons behind these sex differences are still unclear. Therefore, the aims of this study were to investigate sex differences among older adults regarding physical functioning and to study which factors are explaining these sex differences. Methods Cross-sectional data from participants of the OUTDOOR ACTIVE study residing in Bremen, Germany, aged 65 to 75 years, were included in the analyses. Physical functioning was assessed via a self-administered questionnaire using the SF-36 10-item Physical Functioning Scale. Social, lifestyle, and health-related factors were also assessed using the questionnaire. Physical activity was measured objectively using wrist-worn accelerometers over seven consecutive days. Descriptive analyses with absolute and relative frequencies, means and standard deviations, as well as T-tests and chi-square tests were carried out. To test for associations between sex, physical functioning, and several individual factors, linear regressions were performed. Results Data of 2 141 participants (52.1% female) were included in the study. Women and men showed statistically significant differences in physical functioning, with men perceiving fewer limitations than women. On average, women had a physical functioning score of 81.4 ± 19.3 and men 86.7 ± 17.0. Linear regression showed a statistically significant negative association between physical functioning score and sex (β: -0.15, 95% CL: -0.19, -0.10). The association remained statistically significant when adding individual factors to the model. All factors together were only able to explain 51% of the physical functioning-sex association with health indicators and the presence of chronic diseases being the most influential factors. Conclusions We found sex differences in physical functioning, with older women having more limitations than older men. The results showed that health-related factors and chronic diseases played the biggest roles in the different physical functioning scores of women and men. These findings contribute to future longitudinal, more in-depth research. Trial registration German Clinical Trials Register DRKS00015117 (Date of registration 17-07-2018).

Abstract Background Skill and health-related components are required for the assessment of football players’ functional performance, and there is a lack of literature available to measure football players’ functional performance. The study mostly focuses on developing and validating the tool for football players between the ages of 18 and 25. Methods This study used a research methodology that focused on the development and verification of a scale. The research consisted of two distinct stages, namely tool development and validity testing. Firstly, the expert panel did a comprehensive analysis of the items and domains of the questionnaire. Subsequently, the Delphi approach was used to assess the content validity of the questionnaire. Later on, the evaluation tool was officially named the complete functional performance assessment battery (CFPA) for football players in India. Result The CFPA’s newly developed tool has excellent scale-level content validity, which was more than 0.78 for each item in the tool, i.e., 1 (indicated as extremely relevant), the content validity ratio was bigger than 0.49, and each item’s kappa value was found to be 1, which is excellent. Each item’s universal acceptance was found to be 1 for both the item’s quality and content and Aiken’s V index is also greater than 0.81. Conclusion The CFPA is a valid tool in India that can be used to check the functional performance of football players.

Background: Dementia is recognized as a neurodegenerative disease that gradually causes serious cognitive, motor, and functional impairments in affected individuals. This study explored the impact of a meaningful task-oriented intervention on independence in activities of daily living, cognitive status, and physical abilities, including gait speed and balance, among elderly patients diagnosed with mild to moderate dementia. Methods: In this randomized controlled trial, 40 participants aged 60-70, with a Functional Assessment Staging Tool (FAST Scale) score of 1-5, were recruited. They were randomly assigned to either a control group (n=20) receiving standard care, including medication and routine consultation, or an intervention group (n=20) receiving standard care along with eight 45–60-minute sessions of task-oriented interventions. These interventions were centered around familiar daily life activities in the home environment and were conducted twice a week. The primary outcome measure was the participants' independence in activities of daily living, assessed using the Barthel Index. Secondary outcome measures included cognitive function, evaluated using Addenbrooke’s Cognitive Examination-Revised, and physical performance, assessed through the Timed Up and Go test, 10 Meter Walk Test, and Berg Balance Scale. Results: The meaningful task-oriented intervention demonstrated significant improvements in independence in activities of daily living (p

Air Force pilots and some athletes (e.g., in sledding sports) are frequently exposed to high G-forces. High-intensity physical activity is essential to withstand gravitational acceleration, and morphological symmetry and functional movement are directly related to injury in those who perform these activities. However, the relationship between G-endurance and physical imbalance and the effect on physical performance is poorly understood. This study aimed to analyze the physical performance of those exposed to a high load of G-tolerance and who performed high-intensity physical activity. A total of 363 male cadets from the Korean Air Force Academy underwent functional movement screen tests, anatomical structure measurements, G-tests (fourth grade), and body composition and physical fitness tests. Participants were classified into the G-test-pass and -fail groups depending on the G-test results. The pass group showed significantly different bilateral imbalance in active straight leg raises (p < 0.05), while the fail group showed a significant difference in deep squats (p < 0.05), shoulder mobility (p < 0.01), rotary stability (p < 0.05), and functional leg length (p < 0.05). Leg length was significantly correlated with the hurdle step (p < 0.01), inline lunge (p < 0.01), and active straight leg raise (p < 0.01). Functional leg lengths on both sides and structural leg lengths were also significantly correlated (p < 0.01). High body balance positively affects gravitational acceleration and exercise performance. Therefore, functional movement and physical imbalance affect performance in pilots affected by gravitational acceleration. This study can also be applied to strengthen the performance of winter sports athletes affected by gravitational acceleration. [ABSTRACT FROM AUTHOR]

Bouts of military load carriage are rarely completed in isolation; however, limited research has investigated the physiological responses to repeated load carriage tasks. Twelve civilian men (age, 28 ± 8 years; stature, 185.6 ± 5.8 cm; body mass 84.3 ± 11.1 kg and maximal oxygen uptake, 51.5 ± 6.4 mL·kg−1 min−1) attended the laboratory on two occasions to undertake a familiarisation and an experimental session. Following their familiarisation session, participants completed three bouts of a fast load carriage protocol (FLCP; ∼65 min), carrying 25 kg, interspersed with a 65‐min recovery period. Physiological strain (oxygen uptake [V̇O2] and heart rate [HR]) was assessed during the FLCP bouts, and physical performance assessments (weighted counter‐movement jump [wCMJ], maximal isometric voluntary contraction of the quadriceps [MIVC] and seated medicine ball throw [SMBT]) was measured pre and post each FLCP bout. A main effect for bout and measurement time was evident for V̇O2 and HR (both p < 0.001 and Ѡ2 = 0.103–0.816). There was no likely change in SMBT distance (p = 0.201 and Ѡ2 = 0.004), but MIVC peak force reduced by approximately 25% across measurement points (p < 0.001 and Ѡ2 = 0.133). A mean percentage change of approximately −12% from initial values was also evident for peak wCMJ height (p = 0.001 and Ѡ2 = 0.028). Collectively, these data demonstrate that repeated FLCP bouts result in an elevated physiological strain for each successive bout, along with a substantial reduction in lower body power (wCMJ and MIVC). Therefore, future research should investigate possible mitigation strategies to maintain role‐related capability. Highlights: Given the progressively greater internal work rate for each successive load carriage bout (of equal external work rate), individuals responsible for load carriage planning should factor this elevated work rate into their operational planning (e.g., estimated maximal work durations).Elevated work rate for successive bouts should also be considered in other domains such as physical employment standards and development of working patterns.Group level perceptual measures appear to provide a good indication of physiological strain and therefore may provide useful information to commanders regarding the physical strain experienced by their team. [ABSTRACT FROM AUTHOR]

During vertical jump evaluations in which jump height is estimated from flight time (FT), the jumper must maintain the same body posture between vertical takeoff and landing. As maintaining identical posture is rare during takeoff and landing between different jump attempts and in different individuals, we simulated the effect of changes in ankle position from takeoff to landing in vertical jumping to determine the range of errors that might occur in real-life scenarios. Our simulations account for changes in center of mass position during takeoff and landing, changes in ankle position, different subject statures (1.44–1.98 m), and poor to above-average jump heights. Our results show that using FT to estimate jump height without controlling for ankle position (allowing dorsiflexion) during the landing phase of the vertical jump can overestimate jump height by 18% in individuals of average stature and performing an average 30 cm jump or may overestimate by ≤60% for tall individuals performing a poor 10 cm jump, which is common for individuals jumping with added load. Nevertheless, as assessing jump heights based on FT is common practice, we offer a correction equation that can be used to reduce error, improving jump height measurement validity using the FT method allowing between-subject fair comparisons. [ABSTRACT FROM AUTHOR]

The proportion of aged populations is increasing worldwide. Exercise has a palliating effect on some adverse implications of aging. Multicomponent training (MCT) is a recommended form of exercise for the aged population. The aims of this research were to (1) study the number of publications regarding MCT in the aged population following an exponential growth rate; (2) identify the journals, authors, and countries that stand out the most in this area; and (3) describe the most common themes and used keywords in this field. The analysis was performed through the traditional laws of bibliometrics, including, Price's, Lotka's, Bradford's, and Zipf's law. All documents published in journals indexed in the Web of Science (WoS) Core Collection from 2001 to November 2023 that met the inclusion criteria were included. The 485 documents included in this review revealed that the number of annual publications experienced an exponential growth phase, 15 journals with six or more publications formed the core journals on this topic, and the author Mikel Izquierdo and his collaborative network topped the lists of prominent and prolific co-authors. Spain was the leading country in number of publications. Various thematic lines and keywords regarding strength, sarcopenia, quality of life, falls, balance, dual-task exercise, and cognitive and physical functioning were identified. In conclusion, this work confirmed that research on this topic is going through an exponential growth phase and provided detailed information about the journals, authors, and countries involved in the subject, as well as the keywords most frequently used in the subject matter. [ABSTRACT FROM AUTHOR]

Background: Maintaining good functional ability is a key component of healthy ageing and a basic requirement for carrying out activities of daily living, staying independent, and delaying admission to a nursing home. Even though women have a higher life expectancy and slower age-related muscle mass loss than men, they often show a higher prevalence of limitations in physical functioning. However, the reasons behind these sex differences are still unclear. Therefore, the aims of this study were to investigate sex differences among older adults regarding physical functioning and to study which factors are explaining these sex differences. Methods: Cross-sectional data from participants of the OUTDOOR ACTIVE study residing in Bremen, Germany, aged 65 to 75 years, were included in the analyses. Physical functioning was assessed via a self-administered questionnaire using the SF-36 10-item Physical Functioning Scale. Social, lifestyle, and health-related factors were also assessed using the questionnaire. Physical activity was measured objectively using wrist-worn accelerometers over seven consecutive days. Descriptive analyses with absolute and relative frequencies, means and standard deviations, as well as T-tests and chi-square tests were carried out. To test for associations between sex, physical functioning, and several individual factors, linear regressions were performed. Results: Data of 2 141 participants (52.1% female) were included in the study. Women and men showed statistically significant differences in physical functioning, with men perceiving fewer limitations than women. On average, women had a physical functioning score of 81.4 ± 19.3 and men 86.7 ± 17.0. Linear regression showed a statistically significant negative association between physical functioning score and sex (β: -0.15, 95% CL: -0.19, -0.10). The association remained statistically significant when adding individual factors to the model. All factors together were only able to explain 51% of the physical functioning-sex association with health indicators and the presence of chronic diseases being the most influential factors. Conclusions: We found sex differences in physical functioning, with older women having more limitations than older men. The results showed that health-related factors and chronic diseases played the biggest roles in the different physical functioning scores of women and men. These findings contribute to future longitudinal, more in-depth research. Trial registration: German Clinical Trials Register DRKS00015117 (Date of registration 17-07-2018). [ABSTRACT FROM AUTHOR]

(1) Background: The growing prevalence of obesity, diabetes, hypertension, and declining physical fitness among children and adolescents due to sedentary lifestyles has increased attention toward preventive intervention to tackle this issue. This study investigated the age-related effects of high-intensity functional training (HIFT), based on bodyweight resistance exercises conducted during physical education lessons, on muscle mass and strength improvement. (2) Methods: Adolescent males (n = 116) were allocated to four HIFT experimental groups (EGs) and four standard physical education program control groups (CGs) according to age (15, 16, 17, and 18 years [y]). The changes in muscle mass (absolute and relative to height [SMI]), hand–grip strength (HGS), sit-ups (SUs), and standing broad jump (SBJ) were analyzed using two-way analysis of variance (ANOVA) with Bonferroni tests. (3) Results: HIFT significantly increased muscle mass and scores in all strength tests (p < 0.01), while chronological age was significant for HGS (p < 0.01). Interactions between HIFT and chronological age categories were observed for HGS (p = 0.01) and SBJ (p < 0.03). Detailed post hoc tests revealed improvement in muscle mass across all chronological age categories for both approaches (p < 0.05). The 18y-EG group improved HGS over their control peers (p < 0.01), the EG groups significantly improved their SU results (p < 0.01), and SBJ improved in the 15y-EG and 18y-EG groups compared to their control (p < 0.01). (4) Conclusions: This research highlights the effectiveness of a school-based HIFT program in promoting muscle mass gains and enhancing muscle strength among adolescents. The findings offer valuable insights for implementing bodyweight exercises during physical education classes. [ABSTRACT FROM AUTHOR]

Background: Skill and health-related components are required for the assessment of football players' functional performance, and there is a lack of literature available to measure football players' functional performance. The study mostly focuses on developing and validating the tool for football players between the ages of 18 and 25. Methods: This study used a research methodology that focused on the development and verification of a scale. The research consisted of two distinct stages, namely tool development and validity testing. Firstly, the expert panel did a comprehensive analysis of the items and domains of the questionnaire. Subsequently, the Delphi approach was used to assess the content validity of the questionnaire. Later on, the evaluation tool was officially named the complete functional performance assessment battery (CFPA) for football players in India. Result: The CFPA's newly developed tool has excellent scale-level content validity, which was more than 0.78 for each item in the tool, i.e., 1 (indicated as extremely relevant), the content validity ratio was bigger than 0.49, and each item's kappa value was found to be 1, which is excellent. Each item's universal acceptance was found to be 1 for both the item's quality and content and Aiken's V index is also greater than 0.81. Conclusion: The CFPA is a valid tool in India that can be used to check the functional performance of football players. [ABSTRACT FROM AUTHOR]

Objectives: This systematic review with meta-analysis aimed to evaluate the effects of elastic band training (EBT) on body composition and physical performance in apparently healthy older people. Methods: A systematic literature search was conducted between October 2023 and May 2024 using the core collection of six generic databases: PubMed, ProQuest, EBSCOhost, CINAHL Complete, Scopus, and Web of Science. The PRISMA, TESTEX, RoB 2, and GRADE tools assessed the evidence's methodological quality and certainty. The protocol was registered in PROSPERO (code: CRD42024547050). Results: Of 5916 records, 9 randomized and non-randomized controlled trials involving 477 healthy older people were included. Six meta-analyses were performed showing significant improvements in 30-second chair stand (SMD = 3.03; 95 % CI = 0.14 to 5.93; I2 = 100 %; p = 0.04), sit-and-reach (SMD = 2.09; 95 % CI = 0.15 to 4.03; I2 = 100 %; p = 0.04) and timed up-and-go (SMD = 3.10; 95 % CI = 1.67 to 4.53; I2 = 98 %; p 0.05) in favor of EBT were reported. Conclusion: EBT improves 30-second chair stand, sit-and-reach, and timed up-and-go in older people. Nevertheless, the certainty of evidence is very low; thus, not definitive recommendations can be made.

IntroductionUltrasound (US) imaging has emerged as a promising tool for assessing age-related muscle changes. This meta-analysis aimed to comprehensively evaluate the associations between US parameters and muscle strength, as well as sarcopenia-related functional performance in older adults by integrating data from multiple studies.MethodsA systematic literature search was conducted in PubMed, Web of Science, and Embase until June 2023. Studies reporting Pearson’s correlation coefficients between US parameters [echo intensity (EI), muscle thickness (MT), cross-sectional area (CSA), pinnations angle (PA), fascicle length (FL)] and measures of muscle strength or physical performance in older adults were included. Effect sizes were pooled using a random-effects model and presented in forest plots. Heterogeneity was assessed using I2, and publication bias was evaluated using Egger’s test.ResultsTwenty-eight studies met the inclusion criteria. Meta-analysis revealed moderate to strong correlations between EI, MT, and CSA with muscle strength. However, no significant associations were found between US parameters and gait speed. For chair stand tests, the strength of associations varied by test type, with weak correlations observed between echo intensity and muscle thickness with sit-to-stand tests. US parameters did not exhibit significant correlations with the Timed Up and Go test.ConclusionUltrasonographic measurements of echo intensity (EI) and muscle thickness (MT) demonstrated moderate to strong correlations with muscle strength and functional assessments related to sarcopenia. To enhance the accuracy of sarcopenia diagnosis and the effectiveness of management strategies, there is a need for larger, longitudinal studies that evaluate a comprehensive range of ultrasonographic parameters.Systematic review registrationhttps://inplasy.com, identifier INPLASY202410086.

Pharmacological treatments can extend the life span of mice. For optimal translation in humans, treatments should improve health during aging, and demonstrate efficacy when started later in life. Acarbose (ACA) and rapamycin (RAP) extend life span in mice when treatment is started early or later in life. Both drugs can also improve some indices of healthy aging, although there has been little systematic study of whether health benefits accrue differently depending on the age at which treatment is started. Here we compare the effects of early (4 months) versus late (16 months) onset ACA or RAP treatment on physical function and cardiac structure in genetically heterogeneous aged mice. ACA or RAP treatment improve rotarod acceleration and endurance capacity compared to controls, with effects that are largely similar in mice starting treatment from early or late in life. Compared to controls, cardiac hypertrophy is reduced by ACA or RAP in both sexes regardless of age at treatment onset. ACA has a greater effect on the cardiac lipidome than RAP, and the effects of early-life treatment are recapitulated by late-life treatment. These results indicate that late-life treatment with these drugs provide at least some of the benefits of life long treatment, although some of the benefits occur only in males, which could lead to sex differences in health outcomes later in life.

Abstract Background Although Tai Chi (TC) is an evidence-based fall prevention training for older adults, its effective movements remain unclear, which may limit the practice of TC. The purpose of this study was to compare the effectiveness of TC lower extremity exercise (TC LEE), the 8-form Tai Chi (8-form TC), and a stretching control intervention for improving balance and functional mobility among older adults. Methods This was a randomized controlled trial. A total of 102 participants (79 ± 6 years old) were recruited from assisted living facilities. All participants were randomly assigned to the TC LEE (n = 40), 8-form TC (n = 31), and stretching (n = 31) groups in which they received the respective interventions for 16 weeks. The Berg Balance Scale (BBS), Timed Up and Go (TUG) test, and center of pressure (COP) measurements during quiet stance were collected prior to and following the 16-week interventions. Comparisons on all measurements were conducted among all groups. Results Significant improvements were found in BBS (P = 0.002), TUG test (P = 0.001), root mean square amplitude of COP displacement in the anterior–posterior (P = 0.001) and medial–lateral (P = 0.001) directions, and average COP speed in the anterior–posterior (P = 0.001) and medial–lateral (P = 0.001) directions after training in the TC intervention groups compared with the stretching group. The upper limit of the 95% confidence interval (CI) of differences in change scores on the BBS (-0.8 – 1.3 points) between the TC LEE group and the 8-form TC group was within equivalence margins (1.8 points), while the upper limit of the 95% CI of differences in change scores on the TUG test (0.1 – 2.1 s) exceeded the equivalence margin (0.7 s) with the TC LEE group having the larger change scores. Conclusion TC LEE can improve balance and functional mobility in older adults, and may have greater effect than the 8-form TC on improving functional mobility as measured by the TUG test. Trial registration ChiCTR2300070600 retrospectively registered.

Objective: To investigate the factors associated with urinary incontinence in older adults living in nursing homes. Methods: This exploratory, cross-sectional, observational, and quantitative study used exploratory and path analysis (PA). Eighty-six older adults living in nursing homes in the city of Salvador, Brazil, and the city of Brasília, Brazil, were included. Data were collected from January to March 2020, before the Covid-19 pandemic. The following variables were evaluated: sex, age group, functional performance, global cognitive function, comorbidities, and health conditions. We considered urinary incontinence for older adults who answered affirmatively to the "In the last 12 months, have you had an involuntary loss of urine?". Data were initially analyzed by descriptive analysis and nonparametric statistical tests. A PA was performed using generalized structural equation modeling toinvestigate the relationship between the variables of interest and the direct and indirect effects of the independent variables and UI according to the theoretical model. Subsequently, the statistical distributions of the variables and the connections were defined for the regression estimation. After the analysis, the model was respecified, excluding the variables and paths that were not statistically significant to determine the best model. The final model was designed after statistical adjustments, corroborating or not with the theoreticalmodel. Results: Urinary incontinence was associated with educational level, marital status, hypertension,one or more difficulties in basic activities of daily living, mood, insomnia, lossof appetite,fecal incontinence, and difficulty swallowing. In the PA, depression and difficulty swallowing were directly associated with urinary incontinence, and urinary incontinence wasdirectly and significantly associated with insomnia and fecal incontinence. Conclusion: Given the variety of social and health components associated with urinary incontinence, it is necessary to assess, prevent, treat, and rehabilitate this condition in Brazilian nursing homes. Interventions in urinary incontinence demand integrated actions in functional, clinical, and mental healthaspects to promote the well-being of older adults living in nursing homes.

Objectives: To evaluate the association of sleep problems with physical activity and functional limitations in Basic Activities of Daily Living (BADL) in non-institutionalized Brazilian older adults and to investigate if there is a moderating effect of functional limitations in the association between physical activity and sleep problems. Method: This was a cross-sectional study of 22,728 older adults aged 60 or older interviewed in the National Health Survey in 2019. The outcome variable was self-reported sleep problems. The independent variables of interest were the practice of physical activity and functional limitations in BADL. The association between the independent variables and the outcome was assessed using logistic regression models adjusted for covariates. Results: The prevalence of sleep problems was 24.8% (95% CI 23.8–25.8). Physically active individuals were less likely to have sleep problems (OR 0.85; 95% CI 0.72–0.99), while those with functional limitations in BADL (OR 2.10; 95% CI 1.77–2.49) were more likely to have sleep problems, after adjustment for covariates. There was a significant interaction between physical activities and functional limitations in BADL. Conclusions: The prevalence of sleep problems in the Brazilian older adults was associated with physical activity and functional limitations in BADL. Physical activity is associated with lower odds of sleep problems among older adults with functional limitations in BADL.

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This study targeted elderly women over 60 years old (109 persons), divided them into an exercise group and a control group, and implemented a 12-week physical activity program for the exercise group. Body composition, muscle, blood tests, depression, quality of life (QoL), nutritional status, and physical strength were compared and analyzed. The physical activity program was organized through a consultative body of experts, was performed for about 60 min each time in the type and order of exercise appropriate for elderly women, and consisted of a combination of exercise using a band, gymnastics, and stretching. Changes in the muscle index and muscle mass before and after the program were selected as the primary efficacy evaluations. In the exercise group, waist circumference significantly decreased, and the muscle index significantly increased compared to the control group. The number of subjects who showed sarcopenia with a muscle index of 5.4 or less in the exercise group significantly decreased from 22 (38.6%) before program implementation to 13 (22.8%). According to the results of secondary effectiveness evaluation, high-density lipoprotein cholesterol and apolipoprotein (Apo) A were significantly increased in the exercise group compared to the control group, and Apo B, triglyceride, and c-reactive protein showed a significant decrease. Regular physical activity is very important for improving the health and QoL of elderly women, and as a result of applying a customized program, effects such as increased muscle index, improvement of sarcopenia, and improvement of blood lipid status were confirmed. Therefore, it is believed that the physical activity program developed through this study can be applied as a community program for elderly women. [ABSTRACT FROM AUTHOR]

This study aims to determine whether post-hospitalization psychological distress is associated with exercise capacity, physical function and health status in COVID-19 survivors. In this observational study, hospitalized COVID patients were included and divided into two groups according to the mental component summary subscale of the 12-item Short-Form Health Survey. Patients with a score ≤ 45 were included in the psychological distress group, and patients with a score > 45 were included in the non-psychological distress group. The main variables were exercise capacity, physical function, and health status. Patients were evaluated at discharge, 3 months, and at 6 months follow-up. Finally, a total of 60 patients were included in the study. Significant differences were found in exercise capacity, physical function, and health status (p < 0.05), with worse results in the group with psychological distress at discharge and 3 months follow-up. At 6 months after discharge, COVID patients with psychological distress exhibited worse results in exercise capacity, physical function, and health status, being significant exercise capacity and physical function (p < 0.05). It can be concluded that COVID patients with psychological distress at hospital discharge reported worse exercise capacity, physical function and health status at hospital discharge, 3 months and 6 months follow-up. [ABSTRACT FROM AUTHOR]

During vertical jump evaluations in which jump height is estimated from flight time (FT), the jumper must maintain the same body posture between vertical takeoff and landing. As maintaining identical posture is rare during takeoff and landing between different jump attempts and in different individuals, we simulated the effect of changes in ankle position from takeoff to landing in vertical jumping to determine the range of errors that might occur in real-life scenarios. Our simulations account for changes in center of mass position during takeoff and landing, changes in ankle position, different subject statures (1.44–1.98 m), and poor to above-average jump heights. Our results show that using FT to estimate jump height without controlling for ankle position (allowing dorsiflexion) during the landing phase of the vertical jump can overestimate jump height by 18% in individuals of average stature and performing an average 30 cm jump or may overestimate by ≤60% for tall individuals performing a poor 10 cm jump, which is common for individuals jumping with added load. Nevertheless, as assessing jump heights based on FT is common practice, we offer a correction equation that can be used to reduce error, improving jump height measurement validity using the FT method allowing between-subject fair comparisons.

ObjectivesPhysical performance tests are predictive of mortality and may screen for certain health conditions (e.g., sarcopenia); however, their diagnostic and/or prognostic value has primarily been studied in age-limited or disease-specific cohorts. Our objective was to identify the most salient characteristics associated with three lower quarter balance and strength tests in a cohort of community-dwelling adults.MethodsWe applied a stacked elastic net approach on detailed data on sociodemographic, health and health-related behaviors, and biomarker data from the first visit of the Project Baseline Health Study (N = 2,502) to determine which variables were most associated with three physical performance measures: single-legged balance test (SLBT), sitting-rising test (SRT), and 30-second chair-stand test (30CST). Analyses were stratified by age (

ABSTRACT Objectives: to describe the methodological process of cross-cultural adaptation of the PlayPerformance Scale for Children to Brazilian Portuguese. Methods: methodological study of translation and cross-cultural adaptation in six stages: translation, synthesis of translations, back-translation, evaluation by a committee of judges, evaluation by expert nurses, and pretest. The agreement and representativeness of the items were assessed using the content validity index. A minimum value of 80% agreement was considered. Results: all stages of the translation and cross-cultural adaptation process were satisfactory. In the evaluation performed by the committee of judges, all items obtained agreement above 80%. Fifteen pediatric nurses conducted the content validation, suggesting necessary modifications for understanding and application. Thirty children and adolescents with cancer were assessed with the scale for the pre-test. Conclusions: the scale was cross-culturally adapted to Brazilian Portuguese. The need for psychometric testing in a consistent sample is emphasized.

Abstract Background Breast cancer (BC) is one of the most incident types of cancer among women in the world. Although chemotherapy is an effective way to treat several types of cancer, it may also cause serious complications, including cardiotoxicity. This study aimed to identify the impact of chemotherapy on functional capacity, muscle strength and autonomic function. Methods Ten breast cancer patients in therapeutic follow-up (TG) and ten women without comorbidities (CG) participated in the study (46±8.87 years old). Both groups were evaluated at two time points, before and 20 weeks after the start of chemotherapy. Functional capacity and muscle strength were assessed by 6-minute walk test (6MWT) and handgrip test, respectively. Autonomic function was assessed by heart rate variability analysis. Results TG presented greater reductions in the handgrip test for the non-dominant hand (TG ↓15.2%; CG: ↑1.1%, p0.05) and 6MWT total distance (p>0.05). Regarding the heart rate variability variables before and after follow-up period, rMSSD (CG= 39.15±37.66; TG= 14.89±8.28, p= 0.01) and SDNN (CG= 55.77±40.03; TG= 26.30±10.37, p= 0.02) showed effect in the group and time interaction, whereas the LF/HF ratio presented significant difference only in the time analysis (CG= 2.24±2.30; TG= 2.84±1.82, p= 0.04). Conclusion Chemotherapy used in the treatment of breast cancer patients resulted in decreased muscle strength and autonomic imbalance. The data suggests that chemotherapy may carry the risk of developing cardiovascular disease. Trial registration Registration not required.

Background Coronavirus disease 2019 (COVID-19) can cause multiple acute complications. This study evaluated the long-term functional status of older patients hospitalized for acute COVID-19. Methods We analyzed data from a multicenter ambispective cohort study on patients aged >60 years who were hospitalized for COVID-19 at two tertiary care hospitals in Argentina. The participants were contacted by telephone between November 2021 and September 2022 to collect data on their functional status. Ordinal logistic regression was used to identify factors associated with functional limitations after discharge. Results Among the 374 included patients, 205 (55%) showed functional limitations, including 58 (28%) who died during follow-up. The factors independently associated with functional limitations were low baseline functional status (odds ratio [OR]=9.19; 95% confidence interval [CI], 3.35–25.17) and admission to the intensive care unit (OR=4.41; 95% CI, 2.28–8.53). Men had lower odds of functional impairment (OR=0.55; 95% CI, 0.35–0.86). Conclusion Older patients had high mortality rates and poor functional status at 2 years post-discharge for COVID-19. Several factors at the time of discharge were associated with a higher risk of functional limitations and can be used to identify patients’ long-term needs for support and rehabilitation services.

Background The use of ultrasonographic echo intensity (EI) to evaluate skeletal muscle quality and its effects on strength, explosive power, and physical function (PF) in older individuals remains unclear. This meta-analysis evaluated the associations among EI, muscle strength (MS), and PF in older individuals. Methods We conducted a systematic search of the PubMed, Embase, Web of Science, SPORT Discus, and CINAHL databases through October 2022 to identify primary studies examining the association between EI and MS/PF. Effect sizes were computed using a random-effects model and presented using forest plots. Pearson correlation coefficient (r) and I2 statistics were used to measure heterogeneity. Results This meta-analysis included 24 patients. EI demonstrated a negative association with maximal strength (r=-0.351; 95% confidence interval [CI], -0.411 to -0.288; p

Background In people with peripheral artery disease, post hoc analyses of the LITE (Low Intensity Exercise Intervention in Peripheral Artery Disease) randomized trial were conducted to evaluate the effects of walking exercise at a pace inducing ischemic leg symptoms on walking velocity and the Short Physical Performance Battery, compared with walking exercise without ischemic leg symptoms and compared with a nonexercising control group. Methods and Results Participants with peripheral artery disease were randomized to: home-based walking exercise that induced ischemic leg symptoms; home-based walking exercise conducted without ischemic leg symptoms; or a nonexercising control group for 12 months. Outcomes were change of walking velocity over 4 m and change of the Short Physical Performance Battery (0-12, with 12=best) at 6- and 12-month follow-up. A total of 264 participants (48% women, 61% Black race) were included. Compared with walking exercise without ischemic symptoms, walking exercise that induced ischemic symptoms improved change in usual-paced walking velocity over 4 m at 6-month (0.056 m/s [95% CI, 0.019-0.094 m/s]; P

Muscle strength and physical performance are associated with incident fractures and mortality. However, their role in the risk of subsequent fracture and postfracture mortality is not clear. We assessed the association between muscle strength (grip strength) and performance (gait speed and chair stands time) and the risk of subsequent fracture and mortality in 830 men with low-trauma index fracture, who participated in the Osteoporotic Fractures in Men (MrOS) USA Study and had their index measurements assessed within 5 years prior to the index fracture. The annual decline in muscle strength and performance following index fracture, estimated using linear mixed-effects regression, was also examined in relation to mortality. The associations were assessed using Cox proportional hazards models adjusted for age, femoral neck bone mineral density (FN BMD), prior fractures, falls, body mass index (BMI), index fracture site, lifestyle factors, and comorbidities. Over a median follow-up of 3.7 (interquartile range [IQR], 1.3-8.1) years from index fracture to subsequent fracture, 201 (24%) men had a subsequent fracture and over 5.1 (IQR, 1.8-9.6) years to death, and 536 (65%) men died. Index measurements were not associated with subsequent fracture (hazard ratios [HRs] ranging from 0.97 to 1.07). However, they were associated with postfracture mortality. HR (95% confidence interval [CI]) per 1 standard deviation (1-SD) decrement in grip strength: HR 1.12 (95% CI, 1.01-1.25) and gait speed: HR 1.14 (95% CI, 1.02-1.27), and 1-SD increment in chair stands time: HR 1.08 (95% CI, 0.97-1.21). Greater annual declines in these measurements were associated with higher mortality risk, independent of the index values and other covariates. HR (95% CI) per 1-SD annual decrement in change in grip strength: HR 1.15 (95% CI, 1.01-1.33) and in gait speed: HR 1.38 (95% CI, 1.13-1.68), and 1-SD annual increment in chair stands time: HR 1.28 (95% CI, 1.07-1.54). Men who were unable to complete one or multiple tests had greater risk of postfracture mortality (24%-109%) compared to those performed all tests. It remains to be seen whether improvement in these modifiable factors can reduce postfracture mortality. © 2022 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).

Functional assessments are crucial for the evaluation of rehabilitation after total knee (TKA) and hip (THA) arthroplasty. Muscle strength, a key determinant of physical function (PF), is often measured with isokinetic dynamometry (ID), which is considered the gold standard. However, studies lack evaluations of responsiveness—the ability to detect changes over time. This study aims to determine the responsiveness of ID in measuring PF in TKA and THA rehabilitation—is muscle strength a valid indicator for assessing improvement in rehabilitation processes? The pre- and post-surgery PF of 20 osteoarthritis patients (age 55–82) was assessed, using ID, performance-based and self-reported measures. Responsiveness was evaluated by comparing the observed relationship of changes in ID and PF scores with the a priori defined expected relationship of change scores. While the performance-based and self-reported measures showed significant improvements post-surgery (Cohen's d [0.42, 1.05] p < 0.05), ID showed no significant differences. Moderate correlations were found between changes in some ID parameters and selected functional tests (r ≈|0.5|, p < 0.05). Responsiveness was solely found for the peak torque of knee extension at 180°/s on the operated side. Responsiveness is an often-overlooked psychometric property of outcome measurements. The findings suggest that ID may not be fully responsive to the construct of PF after TKA and THA, raising questions about its role and usefulness in this context and the need for more appropriate assessment methods. [ABSTRACT FROM AUTHOR]

This cross-sectional study, conducted at a tertiary care hospital's rehabilitation clinic, aimed to validate Short Physical Performance Battery (SPPB) results obtained through plantar pressure analysis using commercial smart insoles (SPPB-SI) and to compare these results to manually acquired results by an experienced examiner (SPPB-M). This study included 40 independent-walking inpatients and outpatients aged 50 or older. SPPB-SI and SPPB-M were administered concurrently, with the smart insoles providing plantar pressure data that were converted into time–pressure curves. Two interpreters assessed the curves, determining component completion times for the SPPB-SI scores. Among the 40 participants (mean age: 72.98, SD: 9.27), the mean total SPPB-SI score was 7.72 ± 2.50, and the mean total SPPB-M score was 7.95 ± 2.63. The time recordings and measured scores of each SPPB-SI component exhibited high reliability with inter- and intra-interpreter correlation coefficients of 0.9 and 0.8 or higher, respectively. The intraclass correlation coefficient between the total SPPB-SI and SPPB-M scores was 0.831 (p < 0.001), and that between the component scores of the two measurements ranged from 0.837 to 0.901 (p < 0.001). Consistent correlations with geriatric functional parameters were observed for both SPPB-SI and SPPB-M. This study underscores the potential of commercial smart insoles as reliable tools for conducting SPPB assessments. [ABSTRACT FROM AUTHOR]

Background: Coronavirus disease 2019 (COVID-19) can cause multiple acute complications. This study evaluated the long-term functional status of older patients hospitalized for acute COVID-19. Methods: We analyzed data from a multicenter ambispective cohort study on patients aged >60 years who were hospitalized for COVID-19 at two tertiary care hospitals in Argentina. The participants were contacted by telephone between November 2021 and September 2022 to collect data on their functional status. Ordinal logistic regression was used to identify factors associated with functional limitations after discharge. Results: Among the 374 included patients, 205 (55%) showed functional limitations, including 58 (28%) who died during follow-up. The factors independently associated with functional limitations were low baseline functional status (odds ratio [OR]=9.19; 95% confidence interval [CI], 3.35-25.17) and admission to the intensive care unit (OR=4.41; 95% CI, 2.28-8.53). Men had lower odds of functional impairment (OR=0.55; 95% CI, 0.35-0.86). Conclusion: Older patients had high mortality rates and poor functional status at 2 years post-discharge for COVID-19. Several factors at the time of discharge were associated with a higher risk of functional limitations and can be used to identify patients' long-term needs for support and rehabilitation services. [ABSTRACT FROM AUTHOR]

ABSTRACT Knee osteoarthritis (KOA) is a disabling inflammatory disease that makes walking and activities of daily living difficult. This condition can reduce functional capacity and increase the risk for surgery. Objective: To know the functional capacity of patients with KOA evaluated by the six-minute walk test (6MWT). Method: This cross-sectional study evaluated age, gender, weight, BMI, pain (VAS 90-100), physical disability (WOMAC 0-96), degree of joint damage by radiographic imaging, and 6MWT. Results: A total of 176 patients referred by Orthopedics were evaluated, with the inclusion of 164 participants. The mean age was 61.89 ± 10.62 years, 81% women, 67% with cardiovascular disease, hypertension and/or diabetes, 81% obese, with moderate pain (VAS 47.74 ± 29.27) and according to WOMAC, most had severe or very severe disability. The distance covered in the 6MWT was 354.03 ± 102.03m, 67% of the predicted distance. The maximum heart rate achieved was 107.27 ± 17.71 bpm, which characterizes 68% of the predicted by age. Only 12% of the sample showed a marked drop in oxygenation in the 6MWT and 40% had a recovery heart rate in the 1st minute below 15 bpm. Conclusion: Patients with KOA, who were evaluated by the 6MWT, have low functional capacity and physical deconditioning. Level of Clinical Evidence III, Case Control Study.

Background Endometriosis is a condition of the female reproductive system associated with pelvic pain. Chronic pain can affect physical performance by limiting the functional activities, thus, it is hypothesized that women with endometriosis may also present decreased functional capacity, decreased strength, and mobility. The objective of this study is to compare physical performance in women with and without endometriosis. Methods This is a cross-sectional study composed of 115 women equally divided into two groups: the endometriosis group (EG), composed of women with a confirmed diagnosis of the disease by magnetic resonance imaging, and the comparator group (CG), consisting of women without suspicion of the disease. Physical performance (dependent variable) was assessed using hand dynamometry, the 6-min walk test (6MWT), gait speed, and the chair stands test. CG participants performed the tests during the luteal phase of the menstrual cycle. Descriptive statistics, unpaired t-tests, and chi-square tests were used to describe and compare the groups. Multiple linear regression tested the associations adjusted for covariates (age, income, education, age at menarche, and body mass index). Results The EG had worse gait speed (mean difference: −0.11; 95% CI: [−0.18 to −0.04]), weaker grip strength (mean difference: −3.32; 95% CI: [−5.30 to −1.33]), shorter distance covered in the 6MWT (mean difference: −83.46; 95% CI: [−121.38 to −45.53]), and a lower number of repetitions in the chair stands test (mean difference: −8.44; 95% CI: [−10.64 to −6.25]) than the CG, even after adjusting for covariates. Conclusion Grip strength, lower limb strength, mobility, and functional capacity were worse in women diagnosed with endometriosis. Women with endometriosis should be encouraged to engage in physical exercise, adopt healthy lifestyle habits, and participate in rehabilitation activities to control pain, with the aim of reducing functional impairments.

This overview assessed the available body of published peer-reviewed systematic reviews and meta-analyses related to the effects of active exergames compared with active/passive control on physical performance outcomes in older people. The methodological quality and certainty of evidence were assessed using PRISMA, AMSTAR 2, and GRADE. The protocol was registered in PROSPERO (code: CRD42023391694). The main outcomes indicate that 4,477 records, five systematic reviews, and 10 meta-analyses were included. The AMSTAR-2 reported six meta-analyses with high methodological quality, four moderate quality, two systematic reviews with low quality, and three very-low quality. Meta-analysis was performed on balance using the Berg Balance Scale (BBS) and Timed Up-and-Go (TUG) tests, on cardiorespiratory fitness using the 6-min walk test, and on upper and lower limbs muscle strength using the handgrip strength, knee extension, and 30-s chair stand tests. Significant differences in favor of the active exergames groups concerning active/passive groups were reported in BBS (SMD = 0.85; 95% CI = 0.12–1.58; I2 = 96%; p = 0.02), TUG (SMD = 1.44; 95% CI = 0.71–2.16; I2 = 97%; p

BackgroundMuscle mass declines with age, while body adiposity increases. Sarcopenic obesity has been proposed to be particularly deleterious. However, previous methods for estimating muscle mass have been inadequate, and the relative contributions of total body fat versus muscle fat to adverse outcomes have been unclear.MethodIn a large cohort of older men (N = 1 017), we measured muscle mass (D3-creatine dilution), muscle density (high-resolution peripheral quantitative computed tomography in the diaphyseal tibia) as a proxy of muscle fat, and total body fat (dual-energy x-ray absorptiometry). We examined their associations with physical performance (walking speed, grip strength, chair stand time), the risk of mobility outcomes (mobility limitations, mobility disability), and the risk of death over ~5 years.ResultsIn combined models, lower muscle mass and muscle density were independently associated with worse physical performance and the risk of adverse outcomes, while total body fat was minimally related to physical performance and not related to mobility outcomes or mortality. For example, the relative risks for mortality per 1 standardized unit increase in muscle density, muscle mass, and total body fat were 0.84 (95% confidence interval: 0.74, 0.96), 0.70 (0.57, 0.86), and 0.90 (0.64, 1.25), respectively.ConclusionsMuscle mass and muscle density were associated with physical performance and adverse outcomes, and had independent, additive effects. There was little additional contribution of total body fat.

Abstract Background Older adults with cognitive impairment (CI) have higher multimorbidity and frailty prevalence, lower functional status and an increased likelihood to develop dementia, non-cognitive deficits, and adverse health-related events. +AGIL, a real-world program for frail older adults in a primary care area of Barcelona, is a pragmatic, multi-component and integrated intervention implemented since 2016. It includes physical activity, nutrition, sleep hygiene, revision and adequacy of pharmacological treatment, detection of undesired loneliness and screening for CI; to improve physical function in community-dwelling older adults. We aimed to assess the + AGIL longitudinal impact on physical function among community-dwelling frail older persons with CI. Methods An interventional cohort study included data from all the + AGIL consecutive participants from July 2016 until March 2020. Based on the comprehensive geriatric assessment, participants were offered a tailored multi-component community intervention, including a 10-week physical activity program led by an expert physical therapist. Physical performance was measured at baseline, three and six months follow-up. The pre-post impact on physical function was assessed by paired sample t-test for repeated samples. Linear mixed models were applied to analyze the + AGIL longitudinal impact. P-values

s u m m a r y: Purpose: The prevalence of frailty among patients with heart failure is about 45%. Frailty may result in patients' functional decline, falls, disability, and decreased quality of life. Qualitative studies can explore older patients' perceptions of frailty and help patients cope with it. However, a qualitative approach that explores the experience of frailty in older patients living with heart failure is lacking. This study aimed to explore the lived experience of frailty in older patients with heart failure. Methods: This qualitative study applies Giorgi's phenomenological method. Data were collected from October 2019 to August 2020. Thirteen older patients with heart failure aged at least 60 years were recruited using purposive sampling from a medical center in Taiwan. The participants participated in an in-depth interview using a semistructured interview guide. Results: Seven themes were identified: “being reborn at the end of the road but having difficulty recovering”, “living with a disease with an ineffable feeling”, “feeling like being drained: physical weakness and a dysfunctional body”, “struggling with impaired physical mobility and facing unexpected events”, “suffering from mental exhaustion”, “receiving care from loved ones”, and “turning over a new leaf”. Conclusions: Frailty in older patients with heart failure was obscure and difficult to describe. Frailty could be improved by medical intervention, self-management, and social support but was difficult to reverse. Patients with heart failure should be evaluated for frailty using multidimensional assessment tools at first diagnosis and provided frailty-related information so that patients have proper insight into their disease as early as possible.

BackgroundThis study evaluated the association between changes in physical performance and blood pressure (BP) (e.g., systolic [SBP], diastolic [DBP], pulse pressure) in older women.Methods5627 women (mean age 69.8 ± 3.7 y) with grip strength, chair stand, gait speed performance and clinic-measured BP at baseline and at least one follow-up (years 1, 3 or 6) were included. Generalized estimating equation analysis of multivariable models with standardized point estimates described the longitudinal association between physical performance and BP changes in the overall cohort, and in models stratified by baseline cardiovascular disease (CVD), time-varying antihypertensive medication use (none, ≥1) and enrollment age (65-69 y; 70-79 y).ResultsOverall, each z-score unit increment in grip strength was associated with 0.59 mmHg (95% CI 0.10, 1.08) higher SBP, and 0.39 mmHg (95% CI 0.11, 0.67) higher DBP. In stratified models, a standardized increment in grip strength was associated with higher SBP in women without CVD (0.81; 95% CI 0.23-1.39), among antihypertensive medication users (0.93; 95% CI 0.44, 1.41) and non-users (0.37; 95% CI 0.03, 0.71), and in those aged 65-69 y (0.64; 95% CI 0.04, 1.24). Similarly, a standardized increment in any of the three performance measures was associated with modestly higher DBP in antihypertensive medication users, and those aged 70-79 y. Associations between any performance measure and pulse pressure change were not significant.ConclusionThese results suggest a positive, and statistically significant relationship between physical performance and BP that appears to be influenced by CVD history, antihypertensive medication use, and age.

Poor physical function is highly prevalent with aging, and strongly associated with D3-creatine muscle mass/weight. Using metabolomics, we previously identified several triglycerides consisting mostly of polyunsaturated fatty acids that were higher in older adults with good mobility. Here, we sought to further investigate polyunsaturated fatty-acid-related metabolites, i.e., oxylipins, and their associations with D3-creatine muscle mass/weight, gait speed, grip strength, and the Short Physical Performance Battery among 463 older men from the Osteoporotic Fractures in Men Study (MrOS). Oxylipins were measured in fasting serum using liquid chromatography-mass spectrometry. Muscle mass was estimated using D3-creatine dilution and adjusted for body size. We used linear regression to determine oxylipins associated with D3-creatine muscle mass/weight and physical performance, while adjusting for age, education, physical activity, Western dietary pattern, fish oil supplementation, and multiple comparisons. Among 42 oxylipins, none were associated with grip strength and 3 were associated with the Short Physical Performance Battery. In contrast, 18 and 17 oxylipins were associated with D3-creatine muscle mass/weight and gait speed, respectively. A subset of associations between oxylipins and gait speed were partially attenuated by D3-creatine muscle mass/weight. Higher levels of fatty acid alcohol and ketone oxylipins tended to be most strongly associated with gait speed and D3-creatine muscle mass/weight, potentially reflecting anti-inflammatory activity from these select oxylipins in MrOS older men.

Purpose of reviewLow physical function, frailty, and sarcopenia are common complications of chronic kidney disease (CKD). In this article, we review the epidemiology and pathogenesis of low physical function, as well as its associations with adverse outcomes in CKD patients. Additionally, we present various traditional and novel methods for assessment of physical function in CKD patients.Recent findingsIn nondialysis dependent (NDD) and dialysis-dependent CKD patients, the prevalence of low physical function, frailty, and sarcopenia are substantially higher than in the general population. The potential mechanisms of low physical function, frailty, and sarcopenia in CKD patients are due to various factors including underlying kidney disease, co-existing comorbidities, and certain therapeutic interventions utilized in CKD. Increasing evidence has also uncovered the ill effects of impaired physical function on clinical outcomes in CKD patients.SummaryRoutine assessment of physical function is an under-utilized yet important component in the management of CKD patients. Future studies are needed to determine how prescription of exercise and increased daily physical activity can be tailored to optimize the health and well-being of NDD and dialysis-dependent CKD patients in pursuit of successful aging.

Identifying factors that impact physical function in older populations is important for the maintenance of good health with aging. Age-related hyperkyphosis, an excessive curvature in the thoracic spine, affects up to 40% of the older adults and is more common in older females than males. An association of age-related hyperkyphosis with impaired physical function has been reported in numerous studies, however, other studies have reported that a greater magnitude of kyphosis did not associate with impaired physical function. Given the inconsistencies regarding the impact of hyperkyphosis on physical function, the purpose of our study is to perform a systematic review of the existing studies in order to better describe the association between hyperkyphosis and physical function. Prospective and retrospective cohort, case-control, and cross-sectional studies which measure physical function by valid functional tests and questionnaires in older females will be included. We will search Scopus, ISI Web of Science, Cochrane Library, PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and PEDro databases. Studies will be searched and then selected by two independent reviewers based on quality assessment tools from the National Heart, Lung, and Blood Institute (NHLBI). A meta-analysis will be conducted if data reported for individual studies allow. Specifically, if two or more individual studies provide measures of central tendency and variability from any of the categories of physical function measures, data will be gathered for meta-analysis. If a meta-analysis is not possible, data will be synthesized and described in a narrative form by size and variability of effect, direction of effect, and association with hyperkyphosis.