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Performing dual-task (DT) activities is essential for independent living among elderly people. No study has investigated motor performance in various cognitive-motor DT activities, utilizing the Timed Up and Go (TUG) test. This study aimed to compare motor performance between four cognitive-motor DT tests in community-dwelling older adults. The sample consisted of 60 older women. The cognitive tasks performed with the TUG test were (a) mental calculation, (b) memory recall, (c) verbal fluency, and (d) reaction to a stimulus. Lower limb muscle strength was assessed with the 30-Second Chair Stand Test, balance with the Four Square Step Test, and balance confidence with the Activities-specific Balance Confidence Scale. Completion times and DT costs were calculated. Mental calculation (r = 0.63, p < 0.01) and verbal fluency (r = 0.65, p < 0.01) tasks were similarly correlated with the TUG test, and significantly impacted motor performance compared to other DT tests. The reaction to a stimulus test showed a high relationship with the TUG test (r = 0.89, p < 0.01) and had the least impact on motor performance. These findings suggest that the cognitive task type can significantly influence motor performance during DT activities. Adding a cognitive load to the TUG test may improve its ability to identify older adults at risk for falls, aiding in the development of targeted interventions. Further research is required to validate these findings. [ABSTRACT FROM AUTHOR]

Functional mobility tests, such as the L test of functional mobility, are recommended to provide clinicians with information regarding the mobility progress of lower-limb amputees. Smartphone inertial sensors have been used to perform subtask segmentation on functional mobility tests, providing further clinically useful measures such as fall risk. However, L test subtask segmentation rule-based algorithms developed for able-bodied individuals have not produced sufficiently acceptable results when tested with lower-limb amputee data. In this paper, a random forest machine learning model was trained to segment subtasks of the L test for application to lower-limb amputees. The model was trained with 105 trials completed by able-bodied participants and 25 trials completed by lower-limb amputee participants and tested using a leave-one-out method with lower-limb amputees. This algorithm successfully classified subtasks within a one-foot strike for most lower-limb amputee participants. The algorithm produced acceptable results to enhance clinician understanding of a person's mobility status (>85% accuracy, >75% sensitivity, >95% specificity). [ABSTRACT FROM AUTHOR]

Locomotor and balance disorders are major limitations for subjects with hemiparesis. The Timed Up and Go (TUG) test is a complex navigational task involving oriented walking and obstacle circumvention. We hypothesized that subjects with hemiparesis adopt a cautious gait during complex locomotor tasks. The primary aim was to compare spatio-temporal gait parameters, indicators of cautious gait, between the locomotor subtasks of the TUG (Go, Turn, Return) and a Straight-line walk in people with hemiparesis. Our secondary aim was to analyze the relationships between TUG performance and balance measures, compare spatio-temporal gait parameters between fallers and non-fallers, and identify the biomechanical determinants of TUG performance. Biomechanical parameters during the TUG and Straight-line walk were analyzed using a motion capture system. A repeated measures ANOVA and two stepwise ascending multiple regressions (with performance variables and biomechanical variables) were conducted. Gait speed, step length, and % single support phase (SSP) of the 29 participants were reduced during Turn compared to Go and Return and the Straight-line walk, and step width and % double support phase were increased. TUG performance was related to several balance measures. Turn performance (R2 = 63%) and Turn trajectory deviation followed by % SSP on the paretic side and the vertical center of mass velocity during Go (R2 = 71%) determined TUG performance time. People with hemiparesis adopt a cautious gait during complex navigation at the expense of performance. [ABSTRACT FROM AUTHOR]

Traumatic brain injury (TBI) impairs sensory-motor functions, with debilitating consequences on postural control and balance, which persist during the chronic stages of recovery. The Timed Up and Go (TUG) test is a reliable, safe, time-efficient, and one of the most widely used clinical measures to assess gait, balance, and fall risk in TBI patients and is extensively used in inpatient and outpatient settings. Although the TUG test has been used extensively due to its ease of performance and excellent reliability, limited research has been published that investigates the relationship between TUG performance and quantitative biomechanical measures of balance. The objective of this paper was to quantify the relationship between biomechanical variables of balance and the TUG scores in individuals with chronic TBI. Regression models were constructed using six biomechanical variables to predict TUG scores. The model that conservatively removed gait speed (i.e., TUG-1/GS) gave the best results, achieving a root-mean-square error of ~±2 s and explaining over 69% of the variability. [ABSTRACT FROM AUTHOR]

Abstract Background Transient progressive weakness and disability of lower limb during the early stage after TKR will increase the risk of fall, but the superior postoperative strength training mode have not been elucidated for functional restoration. This study aimed to compare whether the isokinetic lower limb training is superior to either isotonic or home isometric exercise during early stage after TKR in older people. Methods A total of 43 recruited old participants (mean age, 68.40 years old) receiving TKR were divided randomly based on the different four-week training modes into three groups including isokinetic, isotonic, and home isometric exercise (control group). The primary outcome was set as functional performance in terms of Timed Up and Go (TUG) test and the secondary outcomes include the peak torque of knee at 60 and 120 degree/ second, Short-Form 36 Health Survey (SF-36), and Western Ontario and McMaster Universities Arthritis index (WOMAC). Results All of the peak torque measurements of the knee improved significantly in both the isokinetic and the isotonic group, but not in the control group. Although isotonic training resulted in more strength gains, a significant enhancement in TUG test was observed in the isokinetic group only (p = 0.003). However, there were no significantly improvement of TUG test after training in other two groups. SF-36 and WOMAC improved after training in all three groups, with no significant difference in the degree of improvement between groups. Conclusion Isokinetic training for 4 weeks following TKR effectively improved all the outcome parameters in this study, including the TUG test, lower limb strength, and functional scores. However, both isokinetic and isotonic training modes could be recommended after TKR because of no significant difference in the degree of improvement between these two groups. Trial registration Clinical trial registration number: NCT02938416. Level of evidence I

Falls and frailty status are often associated with a decline in physical capacity and multifactorial assessment is highly recommended. Based on the functional and biomechanical parameters measured during clinical tests with an accelerometer integrated into smart eyeglasses, the purpose was to characterize a population of older adults through an unsupervised analysis into different physical performance groups. A total of 84 participants (25 men and 59 women) over the age of sixty-five (age: 74.17 ± 5.80 years; height: 165.70 ± 8.22 cm; body mass: 68.93 ± 13.55 kg) performed a 30 s Sit-to-Stand test, a six-minute walking test (6MWT), and a 3 m Timed Up and Go (TUG) test. The acceleration data measured from the eyeglasses were processed to obtain six parameters: the number of Sit-to-Stands, the maximal vertical acceleration values during Sit-to-Stand movements, step duration and length, and the duration of the TUG test. The total walking distance covered during the 6MWT was also retained. After supervised analyses comparison (i.e., ANOVAs), only one of the parameters (i.e., step length) differed between faller groups and no parameters differed between frail and pre-frail participants. In contrast, unsupervised analysis (i.e., clustering algorithm based on K-means) categorized the population into three distinct physical performance groups (i.e., low, intermediate, and high). All the measured parameters discriminated the low- and high-performance groups. Four of the measured parameters differentiated the three groups. In addition, the low-performance group had a higher proportion of frail participants. These results are promising for monitoring activities in older adults to prevent the decline of physical capacities. [ABSTRACT FROM AUTHOR]

Background: Transient progressive weakness and disability of lower limb during the early stage after TKR will increase the risk of fall, but the superior postoperative strength training mode have not been elucidated for functional restoration. This study aimed to compare whether the isokinetic lower limb training is superior to either isotonic or home isometric exercise during early stage after TKR in older people. Methods: A total of 43 recruited old participants (mean age, 68.40 years old) receiving TKR were divided randomly based on the different four-week training modes into three groups including isokinetic, isotonic, and home isometric exercise (control group). The primary outcome was set as functional performance in terms of Timed Up and Go (TUG) test and the secondary outcomes include the peak torque of knee at 60 and 120 degree/ second, Short-Form 36 Health Survey (SF-36), and Western Ontario and McMaster Universities Arthritis index (WOMAC). Results: All of the peak torque measurements of the knee improved significantly in both the isokinetic and the isotonic group, but not in the control group. Although isotonic training resulted in more strength gains, a significant enhancement in TUG test was observed in the isokinetic group only (p = 0.003). However, there were no significantly improvement of TUG test after training in other two groups. SF-36 and WOMAC improved after training in all three groups, with no significant difference in the degree of improvement between groups. Conclusion: Isokinetic training for 4 weeks following TKR effectively improved all the outcome parameters in this study, including the TUG test, lower limb strength, and functional scores. However, both isokinetic and isotonic training modes could be recommended after TKR because of no significant difference in the degree of improvement between these two groups. Trial registration: Clinical trial registration number: NCT02938416. Level of evidence: I [ABSTRACT FROM AUTHOR]

BACKGROUND: The muscle quality index (MQI) has been proposed as a diagnostic tool to detect individuals at risk of limited physical function. OBJECTIVE: Our goal was to examine the relationship of the MQI with physical function and compare its predictive ability with other muscle parameters of strength and mass in an older population. METHODS: Sixty-eight healthy older adults (34 male, 34 female) aged between 69 and 89 years were tested for body composition, MQI, maximum isokinetic concentric KES and physical function including sit-to-stand (STS) time, normal and maximum walking speed (WS), Timed Up and Go (TUG) and static balance. Pearson's correlation was applied to examine the relationship between muscle parameters. Linear regression analysis including age and sex as additional covariates was performed to assess their predictive ability for physical functions. RESULTS: MQI correlated significantly with relative KES (r = 0.611, p < 0.001), total KES (r = 0.829, p < 0.001) and leg lean tissue mass (r = 0.690, p < 0.001). The MQI was not a significant predictor for any physical function (p > 0.05). STS time was a significant predictor for normal WS and TUG time (p < 0.001). Relative KES was a significant predictor for all physical functions except static balance (p < 0.001). No muscle parameter and only age was a significant predictor for static balance. Models explained 20.4%–57.3% of variances of dependent variables. CONCLUSIONS: The MQI is a useful tool to assess leg lean tissue mass and strength of the knee extensor muscles and outperforms STS time. However, STS time and relative KES are more closely related to physical function than the MQI. [ABSTRACT FROM AUTHOR]

Introduction: Knee osteoarthritis affects the elderly, potentially leading to disability, with varying symptoms and fatigue. The hip and knee joints experience discomfort, stiffness, reduced mobility, and depression. Muscle weakness, linked to lower limb atrophy, heightens the risk of falls. Self-efficacy, which is confidence in performing tasks despite discomfort, impacts knee strength and function. Factors such as age, education, depression, and physical decline shape self-efficacy. However, the impact of self-efficacy on osteoarthritis health outcomes is unclear due to reduced activity levels. The present study aims to explore the influence of self-efficacy on knee osteoarthritis function and strength. Aim: To identify the influence of self-efficacy on physical function and muscle strength in individuals with knee osteoarthritis. Materials and Methods: A cross-sectional study was conducted in Department of Physiotheraphy with 73 participants who met the inclusion criteria. The study took place between October 2022 and April 2023, spanning a period of six months, at KS Hegde Charitable Hospital in Mangaluru, Karnataka, India. Hip-knee muscle strength was measured using a push-pull dynamometer, physical function was assessed using the Timed Up and Go (TUG) test, and self-efficacy was evaluated using the Arthritis Self-efficacy Scale-8. All tests were performed once on the same day, with a five-minute rest between each test. Withingroup differences were identified using an Independent T-test, and between-group analysis was conducted using Analysis of Variance (ANOVA). Results: The mean age of the participants was 60.2±6.5 years, and the Basal Metabolic Index (BMI) was 25.2±2.0 kg/m2 . A statistically significant difference with a p-value of 0.001 was observed in hip abductor, knee flexor, knee extensor, and TUG tests between the high and low self-efficacy grades. The time taken for the TUG test also showed significance with a p-value of 0.001. Individuals with high levels of self-efficacy had better scores in physical function as well as muscle strength. No association was found between self-efficacy and KL grading. Conclusion: Participants with higher self-efficacy demonstrated good muscle strength in the hip muscles and good physical function. The study concluded that individuals with high selfefficacy grades had better muscle strength and mobility compared to those with low scores in both strength and mobility.

Performing dual-task (DT) activities is essential for independent living among elderly people. No study has investigated motor performance in various cognitive-motor DT activities, utilizing the Timed Up and Go (TUG) test. This study aimed to compare motor performance between four cognitive-motor DT tests in community-dwelling older adults. The sample consisted of 60 older women. The cognitive tasks performed with the TUG test were (a) mental calculation, (b) memory recall, (c) verbal fluency, and (d) reaction to a stimulus. Lower limb muscle strength was assessed with the 30-Second Chair Stand Test, balance with the Four Square Step Test, and balance confidence with the Activities-specific Balance Confidence Scale. Completion times and DT costs were calculated. Mental calculation (r = 0.63, p < 0.01) and verbal fluency (r = 0.65, p < 0.01) tasks were similarly correlated with the TUG test, and significantly impacted motor performance compared to other DT tests. The reaction to a stimulus test showed a high relationship with the TUG test (r = 0.89, p < 0.01) and had the least impact on motor performance. These findings suggest that the cognitive task type can significantly influence motor performance during DT activities. Adding a cognitive load to the TUG test may improve its ability to identify older adults at risk for falls, aiding in the development of targeted interventions. Further research is required to validate these findings.

Functional mobility tests, such as the L test of functional mobility, are recommended to provide clinicians with information regarding the mobility progress of lower-limb amputees. Smartphone inertial sensors have been used to perform subtask segmentation on functional mobility tests, providing further clinically useful measures such as fall risk. However, L test subtask segmentation rule-based algorithms developed for able-bodied individuals have not produced sufficiently acceptable results when tested with lower-limb amputee data. In this paper, a random forest machine learning model was trained to segment subtasks of the L test for application to lower-limb amputees. The model was trained with 105 trials completed by able-bodied participants and 25 trials completed by lower-limb amputee participants and tested using a leave-one-out method with lower-limb amputees. This algorithm successfully classified subtasks within a one-foot strike for most lower-limb amputee participants. The algorithm produced acceptable results to enhance clinician understanding of a person’s mobility status (>85% accuracy, >75% sensitivity, >95% specificity).

Introduction: Knee osteoarthritis affects the elderly, potentially leading to disability, with varying symptoms and fatigue. The hip and knee joints experience discomfort, stiffness, reduced mobility, and depression. Muscle weakness, linked to lower limb atrophy, heightens the risk of falls. Self-efficacy, which is confidence in performing tasks despite discomfort, impacts knee strength and function. Factors such as age, education, depression, and physical decline shape self-efficacy. However, the impact of self-efficacy on osteoarthritis health outcomes is unclear due to reduced activity levels. The present study aims to explore the influence of self-efficacy on knee osteoarthritis function and strength. Aim: To identify the influence of self-efficacy on physical function and muscle strength in individuals with knee osteoarthritis. Materials and Methods: A cross-sectional study was conducted in Department of Physiotheraphy with 73 participants who met the inclusion criteria. The study took place between October 2022 and April 2023, spanning a period of six months, at KS Hegde Charitable Hospital in Mangaluru, Karnataka, India. Hip-knee muscle strength was measured using a push-pull dynamometer, physical function was assessed using the Timed Up and Go (TUG) test, and self-efficacy was evaluated using the Arthritis Self-efficacy Scale-8. All tests were performed once on the same day, with a five-minute rest between each test. Withingroup differences were identified using an Independent T-test, and between-group analysis was conducted using Analysis of Variance (ANOVA). Results: The mean age of the participants was 60.2±6.5 years, and the Basal Metabolic Index (BMI) was 25.2±2.0 kg/m2. A statistically significant difference with a p-value of 0.001 was observed in hip abductor, knee flexor, knee extensor, and TUG tests between the high and low self-efficacy grades. The time taken for the TUG test also showed significance with a p-value of 0.001. Individuals with high levels of self-efficacy had better scores in physical function as well as muscle strength. No association was found between self-efficacy and KL grading. Conclusion: Participants with higher self-efficacy demonstrated good muscle strength in the hip muscles and good physical function. The study concluded that individuals with high selfefficacy grades had better muscle strength and mobility compared to those with low scores in both strength and mobility. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to explore the feasibility of telehealth-obtained Timed Up and Go (TUG). Methods: The TUG was administered twice during 1 visit. The TUG distance as set up by the participant was compared with the TUG set up by a rater. A second rater scored the TUG virtually, and a third rater scored session recordings twice, 30 days apart. Results: There was a strong and significant correlation between the face-to-face and virtually obtained TUG scores using the patient-identified distances (r = 0.994; 95% confidence interval, 0.957-0.999). Discussion: Virtual TUG measurements are comparable with those measured face-to-face. [ABSTRACT FROM AUTHOR]

Traumatic brain injury (TBI) impairs sensory–motor functions, with debilitating consequences on postural control and balance, which persist during the chronic stages of recovery. The Timed Up and Go (TUG) test is a reliable, safe, time-efficient, and one of the most widely used clinical measures to assess gait, balance, and fall risk in TBI patients and is extensively used in inpatient and outpatient settings. Although the TUG test has been used extensively due to its ease of performance and excellent reliability, limited research has been published that investigates the relationship between TUG performance and quantitative biomechanical measures of balance. The objective of this paper was to quantify the relationship between biomechanical variables of balance and the TUG scores in individuals with chronic TBI. Regression models were constructed using six biomechanical variables to predict TUG scores. The model that conservatively removed gait speed (i.e., TUG-1/GS) gave the best results, achieving a root-mean-square error of ∼±2 s and explaining over 69% of the variability.

Locomotor and balance disorders are major limitations for subjects with hemiparesis. The Timed Up and Go (TUG) test is a complex navigational task involving oriented walking and obstacle circumvention. We hypothesized that subjects with hemiparesis adopt a cautious gait during complex locomotor tasks. The primary aim was to compare spatio-temporal gait parameters, indicators of cautious gait, between the locomotor subtasks of the TUG (Go, Turn, Return) and a Straight-line walk in people with hemiparesis. Our secondary aim was to analyze the relationships between TUG performance and balance measures, compare spatio-temporal gait parameters between fallers and non-fallers, and identify the biomechanical determinants of TUG performance. Biomechanical parameters during the TUG and Straight-line walk were analyzed using a motion capture system. A repeated measures ANOVA and two stepwise ascending multiple regressions (with performance variables and biomechanical variables) were conducted. Gait speed, step length, and % single support phase (SSP) of the 29 participants were reduced during Turn compared to Go and Return and the Straight-line walk, and step width and % double support phase were increased. TUG performance was related to several balance measures. Turn performance (R2 = 63%) and Turn trajectory deviation followed by % SSP on the paretic side and the vertical center of mass velocity during Go (R2 = 71%) determined TUG performance time. People with hemiparesis adopt a cautious gait during complex navigation at the expense of performance.

Purpose: To determine which standardized physical performance tests are being used specifically in the assessment of adult patients before, during, or after undergoing treatment for hematologic malignancy and which of these functional tests have been demonstrated to have a correlation with key objective clinical outcome measures including mortality, progression-free survival, complete remission, hospital readmissions, emergency department visits, and hospital length of stay. Methods: PubMed/MEDLINE electronic databases were searched up to June 2021. Searches were restricted to English language. All resulting studies from the electronic database search were assessed by two reviewers for original research with physical performance data exclusive to patients with hematological malignancy. Studies with confounding intervention or the inclusion of pediatric patients were excluded. The quality of the remaining studies was assessed using PRISMA guidelines and Tooth Criteria by two reviewers, using a third reviewer to resolve any discrepancies. The main characteristics of each article, including sample size, population characteristics, physical performance testing methods, and significant and non-significant findings were extracted and compared. Additionally, one reviewer performed a literature review of the safety of physical performance testing. Results: One thousand two hundred fifty-six screened database results resulted in 14 studies included in the systematic review. All studies scored ≥ 0.59 on the Tooth Criteria, indicating moderate to high quality of reporting. Our review found six recurring measures of objective physical function assessed for correlation with clinical outcomes, primarily morbidity and mortality. The heterogeneity of each study precluded aggregate data analysis. Conclusions: This review was a first step in evaluating which objective physical performance tests are best suited for identifying functional impairment before, during, and after oncologic treatment for adults with blood cancers. Additional studies are needed to determine the optimal objective functional measures to use as a guide in clinical decision-making in the hematologic patient population. [ABSTRACT FROM AUTHOR]

The timed up and go test (TUG) is a common clinical functional balance test often used to complement findings on sensorimotor changes due to aging or sensory/motor dysfunction. The instrumented TUG can be used to obtain objective postural and gait measures that are more sensitive to mobility changes. We investigated whether gait and body coordination during TUG is representative of walking. We examined the walking phase of the TUG and compared gait metrics (stride duration and length, walking speed, and step frequency) and head/trunk accelerations to normal walking. The latter is a key aspect of postural control and can also reveal changes in sensory and motor function. Forty participants were recruited into three groups: young adults, older adults, and older adults with visual impairment. All performed the TUG and a short walking task wearing ultra-lightweight wireless IMUs on the head, chest, and right ankle. Gait and head/trunk acceleration metrics were comparable across tasks. Further, stride length and walking speed were correlated with the participants' age. Those with visual impairment walked significantly slower than sighted older adults. We suggest that the TUG can be a valuable tool for examining gait and stability during walking without the added time or space constraints. [ABSTRACT FROM AUTHOR]

Falls in older people are a major health concern as the leading cause of disability and the second most common cause of accidental death. We developed a rapid fall risk assessment based on a combination of physical performance measurements made with an inertial sensor embedded in a smartphone. This study aimed to evaluate and validate the reliability and accuracy of an easy-to-use smartphone fall risk assessment by comparing it with the Physiological Profile Assessment (PPA) results. Sixty-five participants older than 55 performed a variation of the Timed Up and Go test using smartphone sensors. Balance and gait parameters were calculated, and their reliability was assessed by the (ICC) and compared with the PPAs. Since the PPA allows classification into six levels of fall risk, the data obtained from the smartphone assessment were categorised into six equivalent levels using different parametric and nonparametric classifier models with neural networks. The F1 score and geometric mean of each model were also calculated. All selected parameters showed ICCs around 0.9. The best classifier, in terms of accuracy, was the nonparametric mixed input data model with a 100% success rate in the classification category. In conclusion, fall risk can be reliably assessed using a simple, fast smartphone protocol that allows accurate fall risk classification among older people and can be a useful screening tool in clinical settings. [ABSTRACT FROM AUTHOR]

Abstract Background Midlife hypertension has been recognized as a modifiable risk factor for dementia, but association between blood pressure (BP) in late life and dementia has been inconclusive. In addition, few studies have investigated effects of BP control on dementia incidence in the frail elderly. Thus, this study aimed to investigate the association of BP and dementia incidence with concomitant consideration of physical frailty in the young elderly population. Methods Using the Korean National Health Information Database, we identified 804,024 subjects without history of dementia at age 66. Dementia diagnosis was defined with prescription records of anti-dementia drugs and dementia-related diagnostic codes. Physical frailty was measured using the Timed Up and Go test. Association of BP and dementia incidence with concomitant consideration of physical frailty was investigated using Cox hazards analyses. Results The risks of Alzheimer’s and vascular dementia increased from systolic BP ≥ 160 and 130–139 mmHg, respectively; a significant association of dementia incidence with low BP was not observed. In the analyses stratified by the physical frailty status, low BP was not associated with increased risks of dementia within the groups both with and without physical frailty. Conclusions High BP was associated with increased risks of dementia, especially for vascular dementia, while low BP was not associated with increased risks of any type of dementia in young elderly people, even in those with physical frailty. This study suggests the need for tight BP control in young elderly people, irrespective of frailty status, to prevent dementia and supports the current clinical guidelines of hypertension treatment.

Falls and frailty status are often associated with a decline in physical capacity and multifactorial assessment is highly recommended. Based on the functional and biomechanical parameters measured during clinical tests with an accelerometer integrated into smart eyeglasses, the purpose was to characterize a population of older adults through an unsupervised analysis into different physical performance groups. A total of 84 participants (25 men and 59 women) over the age of sixty-five (age: 74.17 ± 5.80 years; height: 165.70 ± 8.22 cm; body mass: 68.93 ± 13.55 kg) performed a 30 s Sit-to-Stand test, a six-minute walking test (6MWT), and a 3 m Timed Up and Go (TUG) test. The acceleration data measured from the eyeglasses were processed to obtain six parameters: the number of Sit-to-Stands, the maximal vertical acceleration values during Sit-to-Stand movements, step duration and length, and the duration of the TUG test. The total walking distance covered during the 6MWT was also retained. After supervised analyses comparison (i.e., ANOVAs), only one of the parameters (i.e., step length) differed between faller groups and no parameters differed between frail and pre-frail participants. In contrast, unsupervised analysis (i.e., clustering algorithm based on K-means) categorized the population into three distinct physical performance groups (i.e., low, intermediate, and high). All the measured parameters discriminated the low- and high-performance groups. Four of the measured parameters differentiated the three groups. In addition, the low-performance group had a higher proportion of frail participants. These results are promising for monitoring activities in older adults to prevent the decline of physical capacities.

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Abstract Background Physical performance tests are a reflection of health in older adults. The Timed Up and Go test is an easy-to-administer tool measuring physical performance. In older adults undergoing oncologic surgery, an impaired TUG has been associated with higher rates of postoperative complications and increased short term mortality. The objective of this study is to investigate the association between physical performance and long term outcomes. Methods Patients aged ≥65 years undergoing surgery for solid tumors in three prospective cohort studies, ‘PICNIC’, ‘PICNIC B-HAPPY’ and ‘PREOP’, were included. The TUG was administered 2 weeks before surgery, a score of ≥12 seconds was considered to be impaired. Primary endpoint was 5-year survival, secondary endpoint was 30-day major complications. Survival proportions were estimated using Kaplan-Meier curves. Cox- and logistic regression analysis were used for survival and complications respectively. Hazard ratios (aHRs) and Odds ratios (aOR) were adjusted for literature-based and clinically relevant variables, and 95% confidence intervals (95% CIs) were estimated using multivariable models. Results In total, 528 patients were included into analysis. Mean age was 75 years (SD 5.98), in 123 (23.3%) patients, the TUG was impaired. Five-year survival proportions were 0.56 and 0.49 for patients with normal TUG and impaired TUG respectively. An impaired TUG was an independent predictor of increased 5-year mortality (aHR 1.43, 95% CI 1.02-2.02). The TUG was not a significant predictor of 30-day major complications (aOR 1.46, 95% CI 0.70-3.06). Conclusions An impaired TUG is associated with increased 5-year mortality in older adults undergoing surgery for solid tumors. It requires further investigation whether an impaired TUG can be reversed and thus improve long-term outcomes. Trial registration The PICNIC studies are registered in the Dutch Clinical Trial database at www.trialregister.nl: NL4219 (2010-07-22) and NL4441 (2014-06-01). The PREOP study was registered with the Dutch trial registry at www.trialregister.nl: NL1497 (2008-11-28) and in the United Kingdom register (Research Ethics Committee reference 10/H1008/59). https://www.hra.nhs.uk/planning-and-improving-research/application-summaries/research-summaries/?page=15&query=preop&date_from=&date_to=&research_type=&rec_opinion=&relevance=true .

Abstract The objective of this systematic review is to investigate the effects of different methods of resistance training (RT) on functional capacity in older adults. A systematic literature search was conducted using PubMed, SPORTDiscus, Web of Science, CINAHL, Cochrane CENTRAL, ClinicalTrials.gov databases, from inception to December 2021. Eligibility criteria consisted of randomised control trials (RCT’s) involving maximal-intent resistance training (MIRT), where participants (aged 60+) had specific instruction to move ‘as fast as possible’ during the concentric phase of the exercise. Twelve studies were included within the meta-analysis. Divided into functional capacity and strength-related outcomes; Improvements were evident for timed-up-and-go (p = 0.001, SMD: − 1.74 [95% CI − 2.79, − 0.69]) and knee extension one-repetition maximum (1RM) (p = 0.01, SMD: − 1.21, [95% CI − 2.17, − 0.25]), both in favour of MIRT, as well as in 30 s sit-to-stand in favour of T-STR (p = 0.04, SMD: 3.10 [95% CI 0.07, 6.14]). No statistical significance was found for combined functional capacity outcomes (p = 0.17, SMD: − 0.84, [95% CI − 2.04, 0.37]), with near-significance observed in strength-related outcomes (p = 0.06. SMD: − 0.57, [95% CI − 1.16, 0.02]) favouring MIRT. Heterogeneity for FC-outcomes was observed as Tau2 = 4.83; Chi = 276.19, df = 14, I2 = 95%, and for strength-outcomes Tau2 = 1.290; Chi = 109.65, df = 115, I2 = 86%. Additionally, MIRT elicited substantial clinically meaningful improvements (CMI) in Short Physical Performance Battery (SPPB) scores but fell short of CMI in 400 m walk test by 0.6 s. In conclusion, this systematic review highlights the lack of sufficient and quality evidence for maximal- versus submaximal-intent resistance training on functional capacity and strength in community-dwelling older adults. Study limitations revolved around lack of research, low quality (“low” PEDro score), and largely due to the fact many comparison studies did not match their loads lifted (1500 kg vs. 500 kg), making comparisons not possible.

Background: Midlife hypertension has been recognized as a modifiable risk factor for dementia, but association between blood pressure (BP) in late life and dementia has been inconclusive. In addition, few studies have investigated effects of BP control on dementia incidence in the frail elderly. Thus, this study aimed to investigate the association of BP and dementia incidence with concomitant consideration of physical frailty in the young elderly population. Methods: Using the Korean National Health Information Database, we identified 804,024 subjects without history of dementia at age 66. Dementia diagnosis was defined with prescription records of anti-dementia drugs and dementia-related diagnostic codes. Physical frailty was measured using the Timed Up and Go test. Association of BP and dementia incidence with concomitant consideration of physical frailty was investigated using Cox hazards analyses. Results: The risks of Alzheimer's and vascular dementia increased from systolic BP ≥ 160 and 130–139 mmHg, respectively; a significant association of dementia incidence with low BP was not observed. In the analyses stratified by the physical frailty status, low BP was not associated with increased risks of dementia within the groups both with and without physical frailty. Conclusions: High BP was associated with increased risks of dementia, especially for vascular dementia, while low BP was not associated with increased risks of any type of dementia in young elderly people, even in those with physical frailty. This study suggests the need for tight BP control in young elderly people, irrespective of frailty status, to prevent dementia and supports the current clinical guidelines of hypertension treatment. [ABSTRACT FROM AUTHOR]

Background and Objectives In older adults, executive functions are important for daily-life function and mobility. Evidence suggests that the relationship between cognition and mobility is dynamic and could vary according to individual factors, but whether cardiorespiratory fitness reduces the age-related increase of interdependence between mobility and cognition remains unexplored. Research Design and Methods One hundred eighty-nine participants (aged 50–87) were divided into 3 groups according to their age: middle-aged (MA; <65), young older adults (YOA; 65–74), and old older adults (OOA; ≥75). Participants performed Timed Up and Go and executive functioning assessments (Oral Trail Making Test and Phonologic verbal fluency) remotely by videoconference. Participants completed the Matthews questionnaire to estimate their cardiorespiratory fitness (VO2 max in ml/min/kg). A 3-way moderation was used to address whether cardiorespiratory fitness interacts with age to moderate the relationship between cognition and mobility. Results Results showed that the cardiorespiratory fitness × age interaction moderated the association between executive functioning and mobility (β = −0.05; p =.048; R 2 = 17.6; p <.001). At lower levels of physical fitness (<19.16 ml/min/kg), executive functioning significantly influenced YOA's mobility (β = −0.48, p =.004) and to a greater extent OOA's mobility (β = −0.96, p =.002). Discussion and Implications Our results support the idea of a dynamic relationship between mobility and executive functioning during aging and suggest that physical fitness could play a significant role in reducing their interdependency. [ABSTRACT FROM AUTHOR]

Background and Objectives Acute health care use varies by age, with older adults the highest users of acute health care services. Using data from The Irish Longitudinal Study on Ageing (TILDA), the aim of this study was to investigate the association between acute health care utilization (emergency department [ED] visit with or without hospitalization) at baseline and subjective and objective measures of function measured at 4-year follow-up. Research Design and Methods This study represents a secondary analysis of a prospective cohort study, where data from Wave 1 (baseline) and Wave 3 of TILDA were analyzed in conjunction with a public and patient involvement group of older adults. Acute health care utilization was defined as an ED visit with or without hospitalization in the previous 12 months. Function was assessed objectively using the Timed Up and Go (TUG) test and a measure of grip strength, and subjectively using self-report limitations in activities of daily living (ADL) and instrumental ADL (IADL). Results A total of 1 516 participants met the study inclusion criteria. Mean age was 70.9 ± 4.6 years and 48% were male. At baseline, 1 280 participants reported no acute health care use. One hundred and eighteen indicated an ED visit but no hospitalization in the previous 12 months and 118 reported both an ED visit and hospitalization. Adjusting for all covariates, compared to those with no acute health care utilization, those with an ED visit with no hospital admission had poorer TUG performance at follow-up (β = 0.67, 95% confidence interval: 0.34, 1.29, p =.039). Discussion and Implications This paper supports previous research that acute health care events, specifically ED usage, are associated with reduced function for older adults as assessed by TUG at follow-up. No associations were observed for grip strength, ADL, or IADL. Further research is required in this area, exploring ED visits and the possible benefits of evaluating older adults at this stage. [ABSTRACT FROM AUTHOR]

Objetivo. El Síndrome de caídas es un componente de otro, la fragilidad. Establecer fragilidad física en personas mayores con índice de Eichner B y C, portadores de prótesis removibles defectuosas. Métodos. Estudio descriptivo y transversal, adscrito a proyecto Fondo Nacional de Investigación en Salud (FONISSA20I0052) de Chile, en portadores de prótesis defectuosas. Investigaciones demostraron que el equilibrio dinámico, medido con la prueba timed up and go es un buen indicador para detectar a una persona mayoren riesgo de caer. Se determinó en mayores de 70 años, la funcionalidad masticatoria con Índices Eichner B 3 a C3, las caídas en los últimos 6 meses y la prueba Timed up and go. Resultados. La muestra estuvo conformada por 109 personas: 56,9% mujeres y 43,1% de hombres. La media de edad fue 80,7 años. Funcionalidad masticatoria B3: 7,3%; B4: 18,3%; C1: 15,6%; C2: 22,9% y C3: 35,8%. Un 18,3% ha tenido entre 1 y 2 caídas y un 3,7 % ha sufrido 3 o más. Han tenido 1 a 2 caídas, 15% de B3 y 10% de B4. Categorías C, C1 25%, C2 35% y C3 15%. En cuanto a 3 o más caídas, B3, B4 y C2, no tuvieron; C1, 25% y C3, 75%. La media del timed up and go fue de 14,35 seg., con mayores valores en categoría C, quienes presentaron 3 o más caídas, y los menores valores en B. Conclusiones. Mayores de 70 años con prótesis defectuosas y pérdida de funcionalidad masticatoria, presentan mayor fragilidad evidenciada en más caídas.

Background: Physical performance tests are essential for a comprehensive health assessment, and have been described as predictors of disability and muscle mass decline after open chest heart surgery (OHS). We evaluated the association between physical performance tests with clinical outcomes after OHS in younger and older patients. Moreover, the ability of physical performance tests and European System for Cardiac Operative Risk Evaluation (Euroscore II) to predict death was assessed. Methods: Elective OHS patients were evaluated before surgery with handgrip strength (HGS), 30-s Chair-Stand Test (30sCST), and timed up and go test (TUGT). The outcomes were post-surgical complications, total length of stay (LOS), time to walk (TW), time in invasive mechanical ventilation (TIMV), and in-hospital mortality. Data were stratified between patients

Background: Physical performance tests are a reflection of health in older adults. The Timed Up and Go test is an easy-to-administer tool measuring physical performance. In older adults undergoing oncologic surgery, an impaired TUG has been associated with higher rates of postoperative complications and increased short term mortality. The objective of this study is to investigate the association between physical performance and long term outcomes. Methods: Patients aged ≥65 years undergoing surgery for solid tumors in three prospective cohort studies, 'PICNIC', 'PICNIC B-HAPPY' and 'PREOP', were included. The TUG was administered 2 weeks before surgery, a score of ≥12 seconds was considered to be impaired. Primary endpoint was 5-year survival, secondary endpoint was 30-day major complications. Survival proportions were estimated using Kaplan-Meier curves. Cox- and logistic regression analysis were used for survival and complications respectively. Hazard ratios (aHRs) and Odds ratios (aOR) were adjusted for literature-based and clinically relevant variables, and 95% confidence intervals (95% CIs) were estimated using multivariable models. Results: In total, 528 patients were included into analysis. Mean age was 75 years (SD 5.98), in 123 (23.3%) patients, the TUG was impaired. Five-year survival proportions were 0.56 and 0.49 for patients with normal TUG and impaired TUG respectively. An impaired TUG was an independent predictor of increased 5-year mortality (aHR 1.43, 95% CI 1.02-2.02). The TUG was not a significant predictor of 30-day major complications (aOR 1.46, 95% CI 0.70-3.06). Conclusions: An impaired TUG is associated with increased 5-year mortality in older adults undergoing surgery for solid tumors. It requires further investigation whether an impaired TUG can be reversed and thus improve long-term outcomes. Trial registration: The PICNIC studies are registered in the Dutch Clinical Trial database at www.trialregister.nl: NL4219 (2010-07-22) and NL4441 (2014-06-01). The PREOP study was registered with the Dutch trial registry at www.trialregister.nl: NL1497 (2008-11-28) and in the United Kingdom register (Research Ethics Committee reference 10/H1008/59). https://www.hra.nhs.uk/planning-and-improving-research/application-summaries/research-summaries/?page=15&query=preop&date_from=&date_to=&research_type=&rec_opinion=&relevance=true. [ABSTRACT FROM AUTHOR]

Background: A number of assessments exist that evaluate function in ambulatory adults. However, these assessments take for granted the cognitive abilities required for the participant to understand what is being asked of them in order to demonstrate their functional abilities. It has been shown that individuals with Down syndrome (DS) demonstrate lower functional levels when asked to perform additional tasks while walking. Therefore, measurements of function may not be reflective of actual function if the assessment requires additional tasks in those with DS. It is for these reasons the current investigation sought to evaluate four common functional assessments, two with [modified Berg balance test (mBERG) and Functional Gait Assessment (FGA)] and two without [Timed Up and Go (TUG) and Established Populations for Epidemiologic Study in the Elderly (EPESE)] complex tasks. Methods: Adults with DS (n = 19) completed four functional assessments, which were later compared using bivariate Pearson correlation coefficients. Results: There were large associations between simple assessments (TUG–EPESE: r = −0.525, P = 0.021) and complex assessments (FGA–mBERG: r = 0.612, P = 0.005), respectively. The TUG also inversely correlated with the FGA (r = −0.476, P = 0.039), and the EPESE had a large association with mBERG (r = 0.508, P = 0.027). Conclusions: The mBERG may be the best test to replicate real‐world scenarios through its tasks, although it may also be confounded by the cognitive load required to perform the movements as asked. The TUG and EPESE may be more appropriate as mobility assessments because they require very little cognitive attention when completing the tasks. True assessments of mobility ought to err on the side of simple so to not confuse the outcomes with executive functionality. [ABSTRACT FROM AUTHOR]

Abstract Background The aim of this study was to describe the outcome measure timed up and go (TUG) in a large, nationwide cohort of patients with idiopathic normal pressure hydrocephalus (iNPH) pre- and post-operatively. Furthermore, to compare the TUG test to the 10-m walk test (10MWT), the iNPH scale, the modified Rankin scale (mRS) and the Mini Mental State Examination (MMSE), which are commonly applied in clinical assessment of iNPH. Methods Patients with iNPH (n = 1300), registered in the Swedish Hydrocephalus Quality Registry (SHQR), were included. All data were retrieved from the SHQR except the 10MWT, which was collected from patient medical records. Clinical scales were examined pre- and 3 months post-operatively. Data were dichotomised by sex, age, and preoperative TUG time. Results Preoperative TUG values were 19.0 [14.0–26.0] s (median [IQR]) and 23 [18–30] steps. Post-operatively, significant improvements to 14.0 [11.0–20.0] s and 19 [15–25] steps were seen. TUG time and steps were higher in women compared to men (p

Introduction: Impaired postural and reactive balance control is a substantial challenge for children with Cerebral Palsy (CP). Evidence states that Pilates Training (PT) increases strength, endurance and flexibility of the trunk and abdominals, and demonstrates improvement in the deep core muscles which helps body’s ability to relax and improve balance in Spastic Cerebral palsy (SCP) children. Aim: To measure the efficacy of PT on improving balance in SCP children. Materials and Methods: A quasi-experimental pilot study with convenient sampling was conducted for 2 weeks, from March 6, 2024 to March 21, 2024 in Xcell Physiocare, Greater Kailash -I, New Delhi, India among children aged between 5 to 9 years, who were able to understand Hindi and English, with spasticity ranging Shyamoli Sharma, Postgraduate Student, Amity Institute of Health Allied Sciences, Amity University, Noida, Uttar Pradesh, India. Neha Gupta, Associate Professor, Amity University, Noida, Uttar Pradesh, India. Ankur Mittal, Director Xcell Physiocare, Greater Kailash, New Delhi, India. Efficacy of Pilates Training on Balance in Spastic Cerebral Palsy Children: A Pilot Study Abstract ID: PG-61 from 1 to 1+ (Modified Ashworth Scale), level 3 and 4 (Gross Motor Function Classification System) and normal flexibility of lower back muscle. They received 10 minutes of stretching, followed by 45 minutes of PT, 10 repetition each, 4 times a week for 2 weeks. The measurement was performed at baseline and post-treatment using Pediatric Balance Scale (PBS), modified Timed Up and Go (mTUG). Data was analysed using Wilcoxon’s Signed-rank test. Results: The measured variables before and after therapy showed a significant improvement (p<0.05) in both PBS and mTUG. Conclusion: PT is an effective treatment program for improving balance in SCP children. [ABSTRACT FROM AUTHOR]

The timed up and go test (TUG) is a common clinical functional balance test often used to complement findings on sensorimotor changes due to aging or sensory/motor dysfunction. The instrumented TUG can be used to obtain objective postural and gait measures that are more sensitive to mobility changes. We investigated whether gait and body coordination during TUG is representative of walking. We examined the walking phase of the TUG and compared gait metrics (stride duration and length, walking speed, and step frequency) and head/trunk accelerations to normal walking. The latter is a key aspect of postural control and can also reveal changes in sensory and motor function. Forty participants were recruited into three groups: young adults, older adults, and older adults with visual impairment. All performed the TUG and a short walking task wearing ultra-lightweight wireless IMUs on the head, chest, and right ankle. Gait and head/trunk acceleration metrics were comparable across tasks. Further, stride length and walking speed were correlated with the participants’ age. Those with visual impairment walked significantly slower than sighted older adults. We suggest that the TUG can be a valuable tool for examining gait and stability during walking without the added time or space constraints.

The objective was to compare the performance of the International Physical Activity Questionnaire (IPAQ) and Baecke questionnaire to estimate maximal oxygen uptake (VO2max) in healthy older women. One hundred healthy women aged 60 years and older answered the IPAQ and Baecke questionnaires and underwent a cardiopulmonary exercise test. The 6-min walk (6MWT), timed up and go (TUG), and handgrip strength test (HST) were also performed. Mean age and body mass index were 68.5 ± 6.3 years and 27 ± 4.7 kg/m², respectively. No significant correlation was seen between VO2max, IPAQ and Baecke questionnaires. IPAQ did not correlate with any functional tests while Baecke correlated weakly with the 6MWT and TUG test. VO2max correlated significantly with the 6MWT (r = .38; p = .0001), HST (r = .34; p = .001), and TUG (r = -.41; p = .0001). In a multivariate regression model, TUG was the best estimator for VO2max (R² = .217; p = .0001). In conclusion, IPAQ and Baecke questionnaires do not associate significantly with VO2max in older women. [ABSTRACT FROM AUTHOR]

The interaction between oral and/or mental cognitive tasks and postural control and mobility remains unclear. The aim of this study was to analyse the influence of speech production and cognitive load levels on static balance and timed up and go (TUG) during dual-task activities. Thirty healthy young subjects (25 ± 4 years old, 17 women) participated in this study. A control situation and two different cognitive arithmetic tasks were tested: counting backward in increments of 3 and 7 under oral (O) and mental (M) conditions during static balance and the TUG. We evaluated the dual-task cost (DTC) and the effect of speech production (SP) and the level of cognitive load (CL) on these variables. There was a significant increase in the centre of pressure oscillation velocity in static balance when the dual task was performed orally compared to the control situation The DTC was more pronounced for the O than for the M. The SP, but not the CL, had a significant effect on oscillation velocity. There was an increase in TUG associated with the cognitive load, but the mental or oral aspect did not seem to have an influence. Mobility is more affected by SP when the cognitive task is complex. This may be particularly important for the choice of the test and understanding postural control disorders. [ABSTRACT FROM AUTHOR]

Background: Evidence is limited regarding the cumulative effect of risk factors on cognitive decline and the added value of physical function for cognitive function trajectory stratification. We operationalize 13 modifiable dementia risk factors in a scoring system and investigate the relationship between this brain health score, combined with simple measures of physical function, and risk of cognitive decline.Methods: Population-based cohort study of persons aged 50 and older from the Irish Longitudinal Study on Ageing without a history of dementia at baseline who underwent repeated neuropsychological tests (8.08 ± 0.3-year follow-up) were included in the analyses. Exposures were the number of brain health metrics (defined by the Lancet Commission on Dementia Prevention, Intervention, and Care report) at recommended optimal levels. Physical function exposures included Timed Up and Go, dual-task walking speed, and grip strength. Each health metric and physical function measure at the recommended level was assigned a value of 1 and combined to generate brain health scores. Relationship with group-based trajectories of global cognitive function (multidomains composite score), estimated using K-means for longitudinal data, was assessed via ordinal logistic regressions.Results: Among 2 327 participants (mean age, 61 years; 54% women), each additional optimal metric on the brain health score (odds 0.67 [0.62, 0.73]) was associated with reduced odds of cognitive decline. Adding Timed Up and Go (odds 0.71 [0.59, 0.84]) and dual-task walking speed (odds 0.74 [0.63, 0.89]) further improved model fit (ΔAIC = 14.8).Conclusion: These findings support the promotion and maintenance of physical function in addition to brain health strategies to reduce the risk of cognitive decline. [ABSTRACT FROM AUTHOR]

Objective: Falls are important geriatric syndromes that can result in morbidity and mortality in elderly individuals. Many factors increase the risk of falls. To effectively control falls it is important to reveal its relationship with other geriatric syndromes. Materials and Methods: This cross-sectional study was conducted for a period of 4 months from September 2019 to January 2020. Fall risk assessment was done with the Tinetti test and the timed up and go (TUG) test. All patients underwent comprehensive geriatric assessment tests. Results: The study population was composed of 93 women and 57 men, and the mean age was 73±9.2 years. It was observed that the scores obtained from the Katz and Lawton-Brody scales were lower in patients with a high risk of falls. Handgrip strength, skeletal muscle mass index, mininutritional assessment score, and mini-mental status assessment score were lower in these patients. Geriatric depression scale score, fried and SOF frailty index scores, and the number of drugs used were higher in them. Frailty, handgrip strength, gait speed, and depression were independently associated with Tinetti-measured fall risk in linear regression analysis (R²=0.414; p<0.001, p=0.004, p=0.002, p=0.027). IADL and gait speed were found to be independently associated with fall risk according to TUG (R²=0.550; p=0.012, p<0.001). Conclusion: In our study, we concluded that there is a close relationship between the risk of falls and other geriatric syndromes. Effective management of geriatric syndromes will help reduce the risk of falls. [ABSTRACT FROM AUTHOR]

The objective of this systematic review is to investigate the effects of different methods of resistance training (RT) on functional capacity in older adults. A systematic literature search was conducted using PubMed, SPORTDiscus, Web of Science, CINAHL, Cochrane CENTRAL, ClinicalTrials.gov databases, from inception to December 2021. Eligibility criteria consisted of randomised control trials (RCT's) involving maximal-intent resistance training (MIRT), where participants (aged 60+) had specific instruction to move 'as fast as possible' during the concentric phase of the exercise. Twelve studies were included within the meta-analysis. Divided into functional capacity and strength-related outcomes; Improvements were evident for timed-up-and-go (p = 0.001, SMD: − 1.74 [95% CI − 2.79, − 0.69]) and knee extension one-repetition maximum (1RM) (p = 0.01, SMD: − 1.21, [95% CI − 2.17, − 0.25]), both in favour of MIRT, as well as in 30 s sit-to-stand in favour of T-STR (p = 0.04, SMD: 3.10 [95% CI 0.07, 6.14]). No statistical significance was found for combined functional capacity outcomes (p = 0.17, SMD: − 0.84, [95% CI − 2.04, 0.37]), with near-significance observed in strength-related outcomes (p = 0.06. SMD: − 0.57, [95% CI − 1.16, 0.02]) favouring MIRT. Heterogeneity for FC-outcomes was observed as Tau2 = 4.83; Chi = 276.19, df = 14, I2 = 95%, and for strength-outcomes Tau2 = 1.290; Chi = 109.65, df = 115, I2 = 86%. Additionally, MIRT elicited substantial clinically meaningful improvements (CMI) in Short Physical Performance Battery (SPPB) scores but fell short of CMI in 400 m walk test by 0.6 s. In conclusion, this systematic review highlights the lack of sufficient and quality evidence for maximal- versus submaximal-intent resistance training on functional capacity and strength in community-dwelling older adults. Study limitations revolved around lack of research, low quality ("low" PEDro score), and largely due to the fact many comparison studies did not match their loads lifted (1500 kg vs. 500 kg), making comparisons not possible. [ABSTRACT FROM AUTHOR]

Background/Aims: Falling among the elderly is a major public health issue, especially with the advancing age of the baby boomers. The fall risk assessment tests for many lack a context that would bring them closer to everyday life. Thus, immersive virtual reality, which makes it possible to simulate everyday situations, could make it possible to strengthen the quality of the assessment of the risk of falls. However, it is necessary to understand how the use of a virtual reality device influences the motor control of elderly participants. If vestibular physiotherapists use VR to virtualize their tools, what impact would a visual simulation of movement have on motor control in a locomotor task, if this simulation were plausible? Methods: Sixty-two elders (70.8 ± 6.7 years old) completed a Timed Up and Go task under 3 conditions: real, virtual reality, and virtual reality with visual and sound movement information. The virtual reality task takes place in a train either stationary at a station or in uniform linear motion. The time and number of steps were recorded using video, and comparisons between conditions were made using Friedman's test. Results: The results show a significant increase in the time and number of steps in "virtual reality" condition compared to the "real" condition. They do not show significant differences between the 2 virtual conditions. Conclusion: The use of a running virtual train to provide plausible movement is particularly distinguished from vestibular physiotherapy applications with first a fixed visual support partially obscuring the optical flow. This visual aid coupled with the attention dedicated to the task inhibits the effect of the moving environment on locomotion. However, the visual optical flow will potentially have an effect in people with fear of falling. Virtual reality shows great potential for the simulation of realistic environments for the assessment of the risk of falls and opens up avenues for the development of tests. [ABSTRACT FROM AUTHOR]

We evaluated the effect of repetitive trans-spinal magnetic stimulation (rTSMS) in patients with Parkinson's disease (PD) in a randomised, single-blind study. Participants were hospitalised and administered a single trial of rTSMS or sham treatment 2 days a week for 4 weeks. In addition, all participants underwent rehabilitation 5 days a week for 4 weeks. The primary outcome was the difference between the two groups in the mean change from baseline to post-training in the total score on the Unified Parkinson's Disease Rating Scale (UPDRS). Secondary endpoints included the differences between the two groups in the mean change on the UPDRS part III (motor) score and the Timed Up and Go (TUG) score. Eligible participants were randomly assigned to either the rTSMS group (n = 50) or sham group (n = 50). The between-group difference in mean change in the total UPDRS score was 10.28 (95% confidence interval (CI), 4.42 to 16.13; P = 0.014) immediately after intervention from baseline, 5.04 (95% CI, - 5.41 to 15.50; P = 0.024) 3 months after intervention from baseline and 2.38 (95% CI, 7.18 to 11.85; P = 0.045) 6 months after intervention from baseline. Significant differences between groups in UPDRS part III and TUG scores were maintained more strictly than those in the UPDRS total score. These results strongly indicate that rTSMS promotes the effect of rehabilitation on motor function in patients with PD. [ABSTRACT FROM AUTHOR]

Introduction: The C-Brace microprocessor-controlled stance and swing control orthosis has been shown to improve function, mobility, and quality of life. A systematic registry to gather long-term, real-world safety and effectiveness data in patients fit with a C-Brace has not been performed., Methods: International multicenter registry. Patients undergoing routine C-Brace fittings were assessed at baseline and 1 year after fitting. Primary outcomes were fast walking speed (FWS) measured by 25-foot or 10-meter walk test, Timed Up and Go (TUG) and the Activity-specific Balance Confidence (ABC) Scale. Secondary and exploratory outcomes included the Patient-specific Functional Scale (PSFS), falls, pain, PROMIS Pain Interference (PI), and quality of life., Results: 48 subjects with 1-year baseline and follow up data were analyzed. With the C-Brace, FWS improved by + 0.26 ± 0.33 m/s ( p < .0001), TUG by -8.1 ± 14.6 sec ( p < .0001), and ABC by + 24.9 ± 25.8% ( p < .0001). Mean falls reduced from 33 ± 77 to 3.0 ± 5.6 ( p = .0005). PSFS increased by 3.60 ± 2.34 points ( p < .0001). Outcomes for pain, PI and quality of life showed significant improvements with the C-Brace., Conclusion: The C-Brace is an effective option to improve safety, mobility, and quality of life for patients needing a KAFO for ambulation., Competing Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: RL, TK, AM, BP, & AK are employees of subsidiary companies of Ottobock SE & Co. KGaA, the manufacturer of the C-Brace. KH has received consultancies from Otto Bock HealthCare LP., (© The Author(s) 2024.)

Background: There is a lack of tools for selecting patients with advanced lung cancer who benefit the most from systemic treatment. Patient-reported physical function (PRPF) has been identified as a prognostic factor in this setting, but little is known about the prognostic value in advanced non-small-cell lung cancer (NSCLC). The aim of this study was to investigate if measured physical performance was an independent or stronger prognostic factor than PRPF in patients with advanced NSCLC receiving platinum-doublet chemotherapy. Methods: We analyzed patients from a randomized trial comparing immediate and delayed pemetrexed therapy in stage III/IV NSCLC (n = 232) who performed timed up and go (TUG) and 5 m walk test (5 mWT) and reported physical function on the EORTC QLQ-C30 before chemotherapy commenced. Results: Overall, 208 patients performed TUG and 5 mWT and were included in the present study. Poor physical function was significantly associated with poor survival (TUG: HR 1.05, p < 0.01, 5 mWT: HR 1.05, p = 0.03, PRPF: 1.01, p < 0.01), but only PRPF remained an independent prognostic factor in multivariable analyses adjusting for baseline characteristics (HR 1.01, p = 0.03). Conclusions: Patient-reported, but not measured, physical performance was an independent prognostic factor for survival in patients with advanced NSCLC receiving platinum-doublet chemotherapy. [ABSTRACT FROM AUTHOR]

Background: ADS-5102, a delayed-release, extended-release (DR/ER) amantadine, improved walking speed in MS in a Phase 2 trial. Objective: The aim of this study was to present primary results of a Phase 3, double-blind, ADS-5102 trial (INROADS) for walking speed. Methods: Adult participants with MS and walking impairment, not currently using amantadine or dalfampridine, underwent 4-week placebo run-in before randomization 1:1:1 to placebo, 137 or 274 mg/day ADS-5102 for 12 weeks. Primary outcome was the proportion of responders (20% increase in Timed 25-Foot Walk (T25FW) speed) for 274 mg ADS-5102 versus placebo at end of double-blind (Study Week 16). Additional measures included Timed Up and Go (TUG), 2-Minute Walk Test (2MWT), and 12-item Multiple Sclerosis Walking Scale (MSWS-12). Results: In total, 558 participants were randomized and received double-blind treatment. Significantly more participants responded with 274 mg ADS-5102 (21.1%) versus placebo (11.3%). Mean T25FW speed also significantly improved (0.19 ft/s) versus placebo (0.07 ft/s). Other measures were not significant using prespecified hierarchical testing procedure. Adverse events led to discontinuation for 3.8% (placebo), 6.4% (137 mg ADS-5102), and 20.5% (274 mg ADS-5102). Conclusion: INROADS met its primary endpoint, showing a significantly greater proportion of participants with meaningful improvement in walking speed for 274 mg ADS-5102 versus placebo. Numeric dose response was seen for some secondary efficacy outcomes and adverse events. [ABSTRACT FROM AUTHOR]

Introduction: The optimal timing for physical therapy (PT) delivery in Parkinson's disease (PD) is unknown. Our objective was to determine whether spacing physical therapy visits over a longer period of time is beneficial for maintenance of physical function in PD.Methods: A single center, single-blinded, randomized controlled trial of PD participants. Participants (n = 30) were randomized to either burst (two PT sessions weekly for 6 weeks) or spaced (one PT session every 2 weeks for 6 months) PT. 11 participants in each arm completed the study and were analyzed. The primary outcome measure was the Timed Up and Go (TUG) test at baseline and 6 months. The burst group had an additional outcome measure timepoint at the completion of PT at 6 weeks.Results: Neither group achieved a minimal clinically significant benefit in the TUG score (3.5s) at 6 months. The spaced PT TUG scores were maintained when comparing baseline (7.8 ± 1.5s) and 6 month timepoints (7.8 ± 2.6s, p = 0.594). The burst group TUG scores comparing baseline (9.8 ± 3.8s) to 6 weeks (9.1 ± 3.0s) also was maintained (p = 0.365). The burst group worsened, however, when measuring the period from 6 weeks to 6 months (12.1 ± 7.6s, p = 0.034).Conclusions: The spaced PT group had stability of the TUG mobility measure at 6 months, while the burst group had a significant worsening once PT was discontinued after 6 weeks. It is feasible to test these approaches in a future larger comparative effectiveness study. [ABSTRACT FROM AUTHOR]

Purpose: The purpose is to identify objective quantitative parameters for a more accurate evaluation of gait imbalance and relate it to Body Mass Index and age. Methods: 25 multiple sclerosis (MS) and 30 healthy people (CG) aged between 22 and 66 years old (50.4 ± 9.5) were examined in static and dynamic tasks. The demographic data were as follows: body mass (72.4 ± 18.4 kg in CG vs. 66.8 ± 11.5 kg in MS); body height (1.78 ± 0.15 m in CG vs. 1.70 ± 0.11 m in MS); BMI (24.7 ± 4.5 kg/m2 in CG vs. 23.5 ± 3.0 kg/m2 in MS). First, all individuals remained static for baropodometric, pulse and saturation evaluation. Later on, a 6-minute walk and timed up and go tests were performed and additionally included quantitative measurements by barometry and pulse oximeter. Results: The dynamic condition revealed meaningful differences in the foot surface and hindfoot loading, in addition to foot max. loading between study groups. TUG disclosed significantly different results between groups in time and the number of steps. For MS in statics, the moderate positive correlations between BMI and the right forefoot and right hindfoot, and in MS statics, the correlation of the age vs. maximal left foot loading, forefoot loading and hindfoot loading was observed. In the dynamic, the age and plantar angle of the foot had weak relation. Conclusions: Quantitative parameters defining balance deviations of MS are related to BMI and age in statics and dynamics, therefore should be taken into account during MS imbalance assessment. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate the effects of two different exercise training programs periodization on anthropometric and functional parameters in people living with HIV (PLHIV). This was a randomized clinical trial that involved participants (n = 31) living with HIV aged over 18 years and undergoing antiretroviral therapy which were randomized to periodized exercise training (PET; n = 13), non-periodized exercise training (NPET; n = 13), or control group (CON; n = 15). The PET and NPET groups performed 12 weeks of combined training while the CON group maintained the usual activities. Before and after 12 weeks of intervention were measured body composition and perimeters, muscle strength, Short Physical Performance Battery (SPPB) and Timed Up and Go (TUG) test time. Results: The PET and NPET groups increased fat-free mass (p < 0,001), right (p < 0,001) and left thigh perimeter (p < 0,001), muscle strength (p < 0,001), handgrip force (p < 0,001), and reduced the fat mass (p < 0,001), neck perimeter (p < 0,001), chair stand (p < 0,001), and time-up and go test time (p < 0,001) compared to CON. Furthermore, PET was significantly different to increase right thigh and muscle strength (p < 0,05) compared to NPET. Conclusion: Both exercise training periodization protocols were effective to improve body composition and functional outcomes; however, seems that PET presents better results compare to NPET in PLHIV. [ABSTRACT FROM AUTHOR]