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PubMed2002

Comparison of gender and group differences in self-report and physical performance measures in total hip and knee arthroplasty candidates.

Functional measures (fast self-paced walk test, stair climb, and timed up and go) and a self-report measure of function (Lower Extremity Activity Profile) were assessed in 1,805 total hip (761) and knee (1044) arthroplasty candidates (1,063 women, 742 men) preoperatively. Women represented 59% of the study subjects and showed greater disability than men (P <or= .001) in the physical performance and self-report measures. Although the hip arthroplasty group perceived greater functional disability and less satisfaction, the impact of osteoarthritis on the hip and knee was similar in terms of walking and stair performance. Overall, there was low-to-moderate correlation between the self-report and physical performance measures (r = .21- .50).

Activities of Daily Living↗
PubMed1989

Behavioural differences between laying hen populations selected for high and low efficiency of food utilisation.

1. The effects on behaviour of selecting light-hybrid laying hens for high and low efficiency of food utilisation were investigated. Efficiency of food utilisation was measured as the proportional deviation of observed food consumption from expected food consumption. 2. Videograms of the day-time behaviour of 48 to 53-week-old individually caged hens from the F3 generation were analysed by instantaneous sampling. 3. Low-efficiency hens spent more time food-pecking, walking, pacing, and showing escape and aggressive behaviour than did high-efficiency hens. High-efficiency hens spent more than twice as much time resting and sleeping, and were never observed pacing prior to laying. 4. These differences were larger during the 2 h before laying than at other times of day. 5. Low-efficiency hens had poorer plumage, especially on the neck and the breast, and the poorer the plumage the more agitation they showed. 6. Time spent food-pecking was negatively correlated with laying frequency. 7. Differences in the occurrence of specific behaviour patterns, particularly those symptomatic of pre-laying frustration, partly explained differences in efficiency of food utilisation. Selection for higher efficiency of food utilisation might eliminate hens which are most frustrated prior to laying in cages.

Aggression↗
PubMed2006

Influence of carrying heavy loads on soldiers' posture, movements and gait.

Military personnel are required to carry heavy loads whilst marching; this load carriage represents a substantial component of training and combat. Studies in the literature mainly concentrate on physiological effects, with few biomechanical studies of military load carriage systems (LCS). This study examines changes in gait and posture caused by increasing load carriage in military LCS. The four conditions used during this study were control (including rifle, boots and helmet carriage, totalling 8 kg), webbing (weighing 8 kg), backpack (24 kg) and a light antitank weapon (LAW; 10 kg), resulting in an incremental increase in load carried from 8, 16, 40 to 50 kg. A total of 20 male soldiers were evaluated in the sagittal plane using a 3-D motion analysis system. Measurements of ankle, knee, femur, trunk and craniovertebral angles and spatiotemporal parameters were made during self-paced walking. Results showed spatiotemporal changes were unrelated to angular changes, perhaps a consequence of military training. Knee and femur ranges of motion (control, 21.1 degrees +/- 3.0 and 33.9 degrees +/- 7.1 respectively) increased (p < 0.05) with load (LAW, 25.5 degrees +/- 2.3 and 37.8 degrees +/- 1.5 respectively). The trunk flexed significantly further forward, confirming results from previous studies. In addition, the craniovertebral angle decreased (p < 0.001) indicating a more forward position of the head with load. It is concluded that the head functions in concert with the trunk to counterbalance load. The higher muscular tensions necessary to sustain these changes have been associated with injury, muscle strain and joint problems.

Adolescent↗
PubMed1990

Falls efficacy as a measure of fear of falling.

We developed the Falls Efficacy Scale (FES), an instrument to measure fear of falling, based on the operational definition of this fear as "low perceived self-efficacy at avoiding falls during essential, nonhazardous activities of daily living." The reliability and validity of the FES were assessed in two samples of community-living elderly persons. The FES showed good test-retest reliability (Pearson's correlation 0.71). Subjects who reported avoiding activities because of fear of falling had higher FES scores, representing lower self-efficacy or confidence, than subjects not reporting fear of falling. The independent predictors of FES score were usual walking pace (a measure of physical ability), anxiety, and depression. The FES appears to be a reliable and valid method for measuring fear of falling. This instrument may be useful in assessing the independent contribution of fear of falling to functional decline among elderly people.

Accidental Falls↗
PubMed1993

Knee kinematics and kinetics during locomotor activities of daily living in subjects with knee arthroplasty and in healthy control subjects.

BACKGROUND AND PURPOSE: Knee kinematics and kinetics have not been quantitatively studied during gait, stair negotiation, and rising from a chair in the same subjects, either among healthy control subjects or among subjects with knee joint impairments. Despite this paucity of data, rehabilitation goals often include achieving a specific peak knee torque at a specific, fixed angular velocity. SUBJECTS: We compared the kinematic and kinetic performance of the knees in 15 subjects (19 knees) who had undergone knee arthroplasty (KA group) and 11 healthy subjects (22 knees) who served as a control group. The KA group subjects ranged in age from 61 to 78 years, and the control group subjects ranged in age from 26 to 88 years. The KA group subjects had had knee osteoarthritis, were > or = 1 year postsurgery, and were considered fully rehabilitated. METHODS: All subjects were analyzed during barefoot paced walking, stair ascent and descent, and arising from a chair. RESULTS: Compared with the control subjects, the KA group subjects had significantly different knee sagittal range of motion, angular velocities, and maximum knee moments during loaded knee extension. Vertical ground reactions did not differ significantly between groups. Both groups' maximum extension angular velocity exceeded 350 degrees/s during the swing phase of gait, but the maximum loaded extension velocity averaged only 140 degrees/s (during rising from a chair). Maximum knee flexion moments were approximately 10 to 15 N.m/%BW (knee moments normalized to percentage of body weight in newtons). CONCLUSION AND DISCUSSION: We concluded that locomotor ADLs demand relatively slow loaded angular velocities and low knee torques, a factor that should be considered in knee postarthroplasty exercise prescription.

Activities of Daily Living↗
PubMed2003

Specificity of functional mobility measures in older adults after hip fracture: a pilot study.

OBJECTIVE: To determine the relationships between measures of functional mobility (Timed Up and Go [TUG], Self-Paced Walking [SPW], Berg Balance Scale [BBS]) and global functional status (FIM trade mark instrument), the motor component of the FIM instrument (motor FIM), and the mobility/locomotor-specific FIM component (ML-FIM) in older patients admitted to an inpatient rehabilitation program after hip fracture. DESIGN: The TUG, SPW, BBS, and FIM instrument were administered within 24 hr after admission and before discharge to 20 patients undergoing inpatient rehabilitation after a hip fracture. RESULTS: Significant correlations at admission were found between FIM and TUG scores (r = -0.47; p < 0.05), TUG and motor FIM (r = -0.45; p < 0.05), TUG and ML-FIM (r = -0.58; p < 0.01), FIM and BBS (r = 0.60; p < 0.01), motor FIM and BBS (r = 0.50; p < 0.05), and ML-FIM and BBS (r = 0.45; p < 0.05). At discharge, a significant correlation was found between the motor FIM and SPW (r = -0.49; p < 0.05). Change scores between both the motor FIM and ML-FIM and TUG scores were significantly correlated (r = -0.47, p < 0.05, r = -0.50, p < 0.05, respectively). CONCLUSIONS: The FIM instrument, motor FIM, and ML-FIM may not be specific measures of functional mobility in patients with hip fracture.

Activities of Daily Living↗
PubMed2006

Can high-risk older drivers be identified through performance-based measures in a Department of Motor Vehicles setting?

OBJECTIVES: To evaluate the relationship between performance-based risk factors and subsequent at-fault motor vehicle collision (MVC) involvement in a cohort of older drivers. DESIGN: Prospective cohort study. SETTING: Motor Vehicle Administration (MVA) field sites in Maryland. PARTICIPANTS: Of the 4,173 older drivers invited to participate in the study, 2,114 individuals aged 55 to 96 agreed to do so. These analyses focus on 1,910 individuals recruited through MVA field sites. MEASUREMENTS: Gross Impairment Screening Battery, which included Rapid Pace Walk, Head/Neck Rotation, Foot Tap, Arm Reach, Cued Recall, Symbol Scan, Visual Closure subtest of the Motor Free Visual Perception Test (MVPT), Delayed Recall, and Trail Making Test with an Abbreviated Part A and standard Part B; Useful Field of View (UFOV) subtest 2; a Mobility Questionnaire; and MVC occurrence. RESULTS: In drivers aged 55 and older with intact vision (20/70 far visual acuity and 140 degrees visual field), age, sex, history of falls, and poorer cognitive performance, as measured using Trails B, MVPT, and UFOV subtest 2, were predictive of future at-fault MVC involvement. After adjusting for annual mileage, participants aged 78 and older were 2.11 as more likely to be involved in an at-fault MVC, those who made four or more errors on the MVPT were 2.10 times as likely to crash, those who took 147 seconds or longer to complete Trails B were 2.01 times as likely to crash, and those who took 353 ms or longer on subtest 2 of the UFOV were 2.02 times as likely to incur an at-fault MVC. Older adults, men, and individuals with a history of falls were more likely to be involved in subsequent at-fault MVCs. CONCLUSION: Performance-based cognitive measures are predictive of future at-fault MVCs in older adults. Cognitive performance, in particular, is a salient predictor of subsequent crash involvement in older adults. High-risk older drivers can be identified through brief, performance-based measures administered in a MVA setting.

Accidents, Traffic↗
PubMed2005

Effect of leg muscle contraction velocity on functional performance in older men and women.

OBJECTIVES: To explore the relationship between impairment (skeletal muscle strength and contraction velocity) and function in community-dwelling older adults. DESIGN: Cross-sectional. SETTING: University-based human physiology laboratory. PARTICIPANTS: One hundred one men and women (aged 75-90). MEASUREMENTS: Muscle strength and contraction velocity during bilateral leg press (LP) were calculated during one-repetition maximum (1RM) and 40% 1RM. A short physical performance battery (SPPB) and gait speed (GS) from a 400-m self-paced walk assessed function. Sex differences in LP strength and contraction velocity (at 40% 1RM) were assessed. The relationship between these variables and function was also examined. RESULTS: Lower extremity strength and contraction velocity were significantly associated with GS (P=.02 and P=.005, respectively) and SPPB (P<.001 and P=.009, respectively) in men only. Contraction velocity, but not muscle strength, was significantly associated with GS (P<.001) and SPPB (P=.02) in women. CONCLUSION: Sex differences exist in the relationship between impairment (muscle strength and contraction velocity) and function. Older men and women may employ different strategies to achieve success on different functional tasks. These findings may have important implications for clinicians practicing geriatric rehabilitation.

Aged↗
PubMed2006

Elderly patients with hip fracture with positive affect have better functional recovery over 2 years.

OBJECTIVES: To evaluate whether patients with hip fracture with high positive affect had better functioning than those with low positive affect or depressive symptoms in three performance-based measures over 2 years after the fracture. DESIGN: Longitudinal study with assessments at baseline and 2, 6, 12, 18, and 24 months posthospitalization. SETTING: Community. PARTICIPANTS: Four hundred thirty-two patients, aged 65 and older, hospitalized for hip fracture in Baltimore, Maryland, between 1990 and 1991. MEASUREMENTS: High and low positive affect and depressive symptoms were based on baseline Center for Epidemiologic Studies Depression Scale score, usual and rapid walking speed, one chair stand, demographic factors, comorbidities, and history of cognitive impairment. RESULTS: At each follow-up point, respondents with high positive affect at baseline (36% of sample) had faster walking and chair stand speeds than those with low positive affect (13%) and depressive symptoms (51%). For example, at 6 months, the mean usual walking pace was 0.4 m/s (standard error (SE)=0.02) for respondents with high positive affect, versus 0.4 m/s (SE=0.03) and 0.35 m/s (SE=0.02) for patients with low positive affect and depressive symptoms, respectively; adjusted differences were 0.02 (95% confidence interval (CI)=-0.06-0.09) and 0.06 (95% CI=0.01-0.11). Respondents with high positive affect appeared to achieve their maximum improvement in usual pace approximately 6 months before other respondents, but this interaction was not statistically significant. Respondents with consistently high positive affect had the best functioning over the follow-up period. CONCLUSION: High positive affect seems to have a beneficial influence on performance-based functioning after hip fracture.

Affect↗
PubMed1987

The effect of treadmill speed on ventilation at the start of exercise in man.

1. The change in ventilation at the start of exercise was determined during both hyperoxic rebreathing and air breathing in four volunteers. 2. In order to differentiate between the effects of limb-movement frequency and exercise load in terms of oxygen uptake, three treadmill exercises were tested: E1, at an oxygen uptake of 1 l/min on a level treadmill; E2, at 2 l/min on an inclined treadmill at the same speed as E1; E3, at 2 l/min on a level treadmill at a higher speed. All of the exercises were performed at a walking pace. 3. Prior to rebreathing, hyperventilation for 5 min to 20 mmHg was used to reduce carbon dioxide to below the central chemoreceptor threshold. From eleven to fourteen rebreathing experiments were done on each volunteer for each of the three exercises, with the treadmill started at carbon dioxide levels which ranged from 36 (below threshold) to 58 mmHg (above threshold). 4. Ten experiments were performed on each volunteer for each of the three exercises during air breathing, with the treadmill started after 5 min of rest. 5. In both the rebreathing experiments and the air breathing experiments it was found that the change in ventilation at the start of exercise was the same for exercises E1 and E2, and significantly greater for exercise E3. 6. It was concluded that the frequency of limb movement, rather than exercise load (oxygen consumption) is a determinant of the change in ventilation at the start of exercise.

Adult↗
PubMed2000

Factors that modify the association between knee pain and mobility limitation in older women: the Women's Health and Aging Study.

OBJECTIVE: To investigate the influence of pain severity, knee extensor muscle weakness, obesity, depression, and activity on the association between recent knee pain and limitation of usual and fast paced walking, and ability to rise from a chair. METHODS: A cross sectional analysis of 769 older women (mean age 77.8, range 65-101) with physical disability, but no severe cognitive impairment. Severity of knee pain in the past month was classified as none, moderate, or severe. Mobility was measured using timed performance tests. RESULTS: The prevalence of recent knee pain was 53% (408/769). One third of the women with pain reported it to be severe. In general, knee pain was only significantly associated with limited mobility if severe. Obesity, activity and, to a lesser extent, depression intensified the effects of pain. Knee extensor weakness did not. Obesity was a distinctive risk factor in that it substantially increased the risk of mobility limitation, but only in women with pain. In women who had severe pain, activity (walking more than three city blocks in the past week) increased the risk of walking disability more than inactivity. Depression had a minor, but statistically significant effect on walking ability, but not the ability to rise from a chair. CONCLUSION: In older women with recent knee pain, a high pain severity score, obesity, and activity are important factors that increase the risk of mobility limitation.

Aged↗
PubMed1976

Change in symptoms of hypertensive patients after referral to hospital clinic.

At their first visit to a hospital clinic 178 patients referred with a diagnosis of hypertension were given a self-administered questionnaire. They received a similar questionnaire 12 months later. Of the 178 patients 99 were not initially on treatment. Similarly 78 normotensive subjects were drawn randomly from the local population and sent a second questionnaire 10 months later. The symptoms at the first visit of the normotensive controls, the untreated hypertensive patients, and 477 patients on long-term treatment in the hypertension clinic were compared. Treated and untreated hypertensive patients complained more of nocturia and also of unsteadiness either on standing or in the morning. Treated hypertensives complained more of sleepiness, dry mouth, diarrhoea, and, in men, impotence and failure of ejaculation. Similarly, untreated hypertensives complained of excessive depression, blurred vision, and waking headache. Fifty-five of the normotensive subjects and 110 of the newly referred hypertensive patients responded to the second questionnaire. The proportions losing and gaining symptoms were calculated together with the proportions always complaining and never complaining of a symptom. Hypertensive patients tended to lose the complaints of unsteadiness and headache but to gain the symptoms of vivid dreams, a slow walking pace, and diarrhoea. The net improvement for a symptom was defined as the excess of patients who lost a symptom over those who gained the symptom, expressed as a percentage. Over the follow-up period the control subjects had a net improvement averaged over 14 symptoms of +2-4 per cent. A similar result was obtained for the hypertensive patients of +2-0 per cent, the symptoms lost being balanced by those gained. The changes in symptoms with time were related to the changes in blood pressure and it is suggested that only headache, 'unsteadiness, lightheadedness, or faintness' and nocturia can actually result from raised blood pressure and then only in a proportion of patients complaining of these symptoms.

Blood Pressure↗
PubMed1979

Assessment of respiratory function in patients with chronic obstructive airways disease.

The reproducibility of some respiratory function tests and a simple self-paced walking test were assessed in 13 patients with stable chronic obstructive airways disease by making observations on six occasions at two to three weekly intervals. The coefficients of variation of the various tests were as follows: forced expiratory volume in one second, +/- 14.8%; forced vital capacity, +/- 11.1%; transfer factor (single breath carbon monoxide), +/- 15%; total lung capacity, +/- 8.8% by helium dilution and +/- 8.3% by body plethysmography; increase in heart rate and minute ventilation for an increase in oxygen uptake of 0.5 1 min-1, +/- 19.4% and +/- 16.3%; distance covered in a 12-minute walking test, +/- 8.2%. The 12-minute distance increased significantly over the first three studies. The considerable variations in the result of these tests in subjects with apparently stable clinical states and without changes in treatment should be considered when assessing the results of changes in treatment.

Humans↗
PubMed1993

Determinants of independence in the elderly.

The purpose of this study was to compare strength, flexibility, and cardiorespiratory fitness of the elderly living independently (n = 64) with those in rest or nursing homes (n = 61), and to identify those variables most strongly associated with an independent lifestyle. Quantitative levels of independence (Incapacity Index) and of activity were determined by questionnaires. Flexibility was measured using the Leighton Flexometer. Strength was measured using a modified sphygmomanometer. Cardiorespiratory fitness was measured using a self-paced walking test. Body size factors were also determined. Independent and dependent subjects were significantly different in age, which imposed a limitation on interpretation of these data. However, this factor was accounted for statistically in the analyses. Independent individuals compared to dependent ones showed significantly greater flexibility, activity levels, and choice of walking speed. Through multiple regression analysis, it was found that 40% of the variance in Incapacity Index was associated with participation in outdoor activities, greater shoulder flexibility, and a faster normal walking speed (> 1.0 m.s-1).

Activities of Daily Living↗
PubMed2026

Causal Associations and Potential Mediating Factors between Sarcopenia-Related Traits and Heart Failure Risk: A Mendelian Randomization Study.

INTRODUCTION: In this two-sample, two-step Mendelian randomization (MR) study, we aimed to elucidate the causal associations between sarcopenia-related characteristics and heart failure (HF) risk, and to identify the factors mediating these associations, with a particular focus on the mediating roles of obesity and sedentary habits. METHODS: Genetic instruments for appendicular lean mass (ALM), hand grip strength (HGS), walking pace (WP), and potential mediators were extracted from genome-wide association studies. Inverse-variance weighting (IVW) was used as the primary analytical method, supplemented by MR-Egger regression, weighted median, and weighted mode analyses. Sensitivity analyses including Cochran's Q test and MR-Egger intercept method were performed to assess heterogeneity and pleiotropy. Bidirectional MR was conducted to exclude reverse causation. RESULTS: IVW revealed that a faster genetically predicted WP was associated with lower HF risk (odds ratio [OR] 0.44, 95% confidence interval [CI] 0.33-0.60, p = 5.806 &#xd7; 10-7). The mediation analysis indicated that body mass index (BMI) accounted for 32% of this effect, while time spent watching television accounted for 14%. Elevated ALM showed a slight but significant positive association with HF risk (OR 1.06, 95% CI 1.03-1.09, p = 5.437 &#xd7; 10-4). However, multivariable MR adjusting for BMI completely attenuated this association (p = 0.693), suggesting ALM reflects overall body composition rather than isolated muscle mass. No significant associations were found between HGS and HF. Bidirectional MR showed no robust reverse effects. CONCLUSIONS: These findings suggest that genetically predicted increased WP exerts beneficial effects against HF, partially mediated by obesity and sedentary habits. Targeting weight management and anti-sedentary interventions may mitigate HF risk in individuals with sarcopenia-related characteristics.

Heart failure↗
PubMed2000

Comparison of different methods of obtaining orthostatic vital signs.

The purpose of this study was to compare two lying and standing procedures for measuring orthostatic vital signs. Thirty-five normotensive participants (mean age 21.6 years)participated in a randomized crossover study. Measures of blood pressure (BP), heart rate, and dizziness were collected at different lying and standing times. AU subjects participated in a standardized walk paced at 4 miles per hour prior to lying. Using analysis of variance (ANOVA) with post hoc contrasts, the mean systolic BP differed between 5 and 10 minutes of lying (F = 21.33, p < .001) and the mean diastolic BP tended to differ between those time points (F = 5.23, p < .03). The mean standing systolic BP and dizziness rating were different between 0- and 2-minute intervals (F = 8.36, p < .01 and F = 7.15, p < .10). In normotensive participants following standardized exercise, orthostatic vital signs stabilized after lying 10 minutes.

Adult↗
PubMed2001

Pneumatic bracing and total contact casting have equivocal effects on plantar pressure relief.

The purpose was to examine and compare plantar pressures produced in healthy subjects while wearing a running shoe (RS), total contact cast (TCC) and 'customized' pneumatic pre-fabricated walking brace (PWB). A repeated measures design was used to compare the plantar pressures recorded for three footwear types (RS, TCC, PWB) in two body regions (forefoot, heel). Nine healthy subjects walked at a self-selected walking pace on a motorized treadmill while wearing the RS, TCC and PWB (ordered randomization). Following a five-minute acclimatization period on the treadmill with each footwear device, plantar pressures were recorded from 84 constant gait speed and step length steps using the Pedar system of in-shoe array of capacitive sensors embedded in an insert. Mean spatially averaged peak plantar pressures were recorded for the metatarsal heads and heel region for each footwear device worn by each subject. A two-way analysis of variance with repeated measures and post-hoc Tukey tests analysed the data with a significance level of p=.05. The main effects of footwear (p=.005) and body region (p=.000), and interaction effect (body region x footwear device) (p=.000) were significant. Unloading of the forefoot was 63.72% and 58.77% for the TCC and PWB, respectively, whereas loading under the heel was increased 37.09% and 34.11% for the same two devices, respectively. Patients who develop neuropathic plantar ulcers in the forefoot region, but not in the heel region, may benefit from a reduction in plantar pressures by using either the TCC or a 'customized' PWB. An alternative footwear device still needs to be found for those patients with heel ulceration.

Adult↗
PubMed1993

Physical exertion and immediate mental performance of sixth-grade children.

The intent of this investigation was to examine the potential influence of varying durations of physical exertion at different times of the day on immediate mathematical performance by 120 sixth-grade boys and girls. Subjects were assigned to two control and two treatment groups (Solomon Four-group Design), with treated subjects administered physical exertion (paced walking at controlled moderate intensity) for durations of 20, 30, and 40 min. at three different times of the school day [8:30 a.m., 11:50 a.m. (before lunch), 2:20 p.m.] over 3 weeks. After each exertion session, subjects were immediately administered a 90-sec. mathematical computation test. Analysis indicated no significant differences in mathematical performance at any duration in the morning, but scores were significantly higher at 11:50 a.m. and 2:20 p.m. at 30- and 40-min. durations in comparison to the 20-min. duration. There were no differences by gender of subject.

Arousal↗