scholarly journals Inferring Physical Function From Wearable Activity Monitors: Analysis of Free-Living Activity Data From Patients With Knee Osteoarthritis (Preprint)

2018 ◽  
Author(s):  
Vibhu Agarwal ◽  
Matthew Smuck ◽  
Christy Tomkins-Lane ◽  
Nigam H Shah
Keyword(s):  
Physical Function ◽  
Physical Performance ◽  
Model Performance ◽  
Daily Activities ◽  
Walk Test ◽  
Free Living ◽  
Activity Data ◽  
Activity Monitors ◽  
Clinical Assessments ◽  
Function Profile

BACKGROUND Clinical assessments for physical function do not objectively quantify routine daily activities. Wearable activity monitors (WAMs) enable objective measurement of daily activities, but it remains unclear how these map to clinically measured physical function measures. OBJECTIVE This study aims to derive a representation of physical function from daily measurements of free-living activity obtained through a WAM. In addition, we evaluate our derived measure against objectively measured function using an ordinal classification setup. METHODS We defined function profiles representing average time spent in a set of pattern classes over consecutive days. We constructed a function profile using minute-level activity data from a WAM available from the Osteoarthritis Initiative. Using the function profile as input, we trained statistical models that classified subjects into quartiles of objective measurements of physical function as measured through the 400-m walk test, 20-m walk test, and 5 times sit-stand test. Furthermore, we evaluated model performance on held-out data. RESULTS The function profile derived from minute-level activity data can accurately predict physical performance as measured through clinical assessments. Using held-out data, the Goodman-Kruskal Gamma statistic obtained in classifying performance values in the first quartile, interquartile range, and the fourth quartile was 0.62, 0.53, and 0.51 for the 400-m walk, 20-m walk, and 5 times sit-stand tests, respectively. CONCLUSIONS Function profiles accurately represent physical function, as demonstrated by the relationship between the profiles and clinically measured physical performance. The estimation of physical performance through function profiles derived from free-living activity data may enable remote functional monitoring of patients.

Orthoses versus gait retraining: Immediate response in improving physical performance measures in healthy and medial knee osteoarthritic adults

2020 ◽  
Vol 234 (7) ◽  
pp. 749-757
Author(s):  
Saad Jawaid Khan ◽  
Soobia Saad Khan ◽  
Juliana Usman ◽  
Abdul Halim Mokhtar ◽  
Noor Azuan Abu Osman
Keyword(s):  
Knee Osteoarthritis ◽  
Physical Function ◽  
Physical Performance ◽  
Performance Measures ◽  
Repeated Measures ◽  
Valgus Knee ◽  
Walk Test ◽  
Gait Retraining ◽  
Knee Brace ◽  
Medial Knee

The conservative techniques of treating knee osteoarthritis (kOA) include wearing orthoses such as knee braces and laterally wedged insoles and applying gait modification techniques such as toe-in gait and toe-out gait. This study aimed at assessing the immediate effects of these techniques in improving physical function of healthy and kOA participants. Five Osteoarthritis Research Society International (OARSI) recommended performance-based tests were randomly applied to measure physical function: (1) 30-second chair stand test (30CST), (2) 40-m (4 × 10) fast-paced walk test (40FPW), (3) stair climb test (SCT), (4) timed up and go test (TUGT) and (5) 6-minute walk test (6MWT) during a single-visit on 20 healthy and 20 kOA patients (age: 59.5 ± 7.33 and 61.5 ± 8.63 years, BMI: 69.95 ± 9.86 and 70.45 ± 8.80 kg/m2). The interventions included natural gait, toe-out gait, toe-in gait, laterally wedged insoles and knee brace. Analysis was performed through repeated-measures ANOVA and independent sample t-test. 30CST and TUGT showed no significant differences for the five test conditions ( p > 0.05). Toe-out showed profound effects via pairwise comparison in impairing the physical function while knee brace improved it during 40FPW, SCT and 6MWT. In general, all the tested conservative techniques except laterally wedged insoles had immediate effects on physical performance measures in both healthy and medial knee osteoarthritis participants. The valgus knee brace improved the parameters the most, while toe-out gait impaired them the most. Future studies can develop strategies for improving gait retraining methods on the basis of issues identified by this study.

Physical Functional Assessment in Older Adults

2020 ◽  
pp. 1-9
Author(s):  
E. Patrizio ◽  
R. Calvani ◽  
E. Marzetti ◽  
M. Cesari
Keyword(s):  
Older Adults ◽  
Physical Function ◽  
Physical Performance ◽  
Handgrip Strength ◽  
Objective Assessment ◽  
Multiple Chronic Conditions ◽  
Physical Domain ◽  
Walk Test ◽  
Predictive Capacity ◽  
Timed Up And Go

The evaluation of the physical domain represents a critical part of the assessment of the older person, both in the clinical as well as the research setting. To measure physical function, clinicians and researchers have traditionally relied on instruments focusing on the capacity of the individual to accomplish specific functional tasks (e.g., the Activities of Daily Living [ADL] or the Instrumental ADL scales). However, a growing number of physical performance and muscle strength tests has been developed in parallel over the past three decades. These measures are specifically designed to: 1) provide objective results (not surprisingly, they are frequently timed tests) taken in standardized conditions, whereas the traditional physical function scales are generally self- or proxy-reported measures; 2) be more sensitive to changes; 3) capture the real biology of the function through the assessment of standardized tasks mirroring specific functional subdomains; and 4) mirror the quality of specific mechanisms underlying more complex and multidomain functions. Among the most commonly used instruments, the usual gait speed test, the Short Physical Performance Battery, the handgrip strength, the Timed Up-and-Go test, the 6-minute walk test, and the 400-meter walk test are widely adopted by clinicians and researchers. The clinical and research importance of all these instruments has been demonstrated by their predictive capacity for negative health-related outcomes (i.e., hospitalization, falls, institutionalization, disability, mortality). Moreover, they have shown to be associated with subclinical and clinical conditions that are also not directly related to the physical domain (e.g., inflammation, oxidative stress, overall mortality). For this reason, they have been repeatedly indicated as markers of wellbeing linked to the burden of multiple chronic conditions rather than mere parameters of mobility or strength. In this work protocols of the main tests for the objective assessment of physical function in older adults are presented.

scholarly journals Peer-led exercise program for ageing adults to improve physical functions - a randomized trial

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
D. R. Bouchard ◽  
J. V. Olthuis ◽  
V. Bouffard-Levasseur ◽  
C. Shannon ◽  
T. McDonald ◽  
...  
Keyword(s):  
Physical Function ◽  
Controlled Trial ◽  
Intervention Group ◽  
Exercise Program ◽  
Control Group ◽  
Walk Test ◽  
Blood Draw ◽  
Chair Stand ◽  
Significant Difference ◽  
Physical Functions

Abstract Background A peer-led exercise program is one way to empower people sharing similar characteristics to encourage others to be active, but there is a lack of evidence that these programs have physical function and other benefits when delivered to ageing adults. Methods This randomized controlled trial lasting 12 weeks proposed an exercise peer-led program offered to 31 adults aged 50 and above, twice a week, by a trained leader of the same age from March to May 2019. The program was offered for free with limited space and equipment. Valid tests of physical function (e.g., 30-s chair stand, 6-min walk test) were used to assess the functional benefits. Psychosocial outcomes were assessed using self-reported questionnaires and metabolic outcomes via a fasted blood draw. Results A significant difference was found between pre-and post-values in most physical function tests in the intervention group (all p < 0.05). When adjusted for potential confounders, the intervention group was significantly associated with a more significant improvement on the chair stand test (ß = .26; p < 0.001; r2 = 0.26), the arm curl (ß = .29; p < 0.001; r2 = 0.49), as well as the 6-min walk test (ß = -.14; p < 0.001; r2 = 0.62) compared with the control group. Using repetitive measures generalized linear model, the interaction between the changes and the group was significant for all three tests. Benefits were also observed for participants’ stress level and perceived health in the intervention group compared to the control. Finally, no significant difference was observed between groups for metabolic health. Conclusions The current work suggests that a 12-week peer-led exercise program can improve physical function for adults age 50 and above. Trial registration NCT03799952(ClinicalTrials.gov) 12/20/2018.

Pain intensity and physical performance among individuals with fibromyalgia in mid-to-late life: The influence of depressive symptoms

2021 ◽  
pp. 135910532110092
Author(s):  
Dylan G Serpas ◽  
Laura Zettel-Watson ◽  
Barbara J Cherry
Keyword(s):  
Depressive Symptoms ◽  
Pain Intensity ◽  
Physical Performance ◽  
Walk Test ◽  
Mediation Analyses ◽  
Mediating Role ◽  
6 Minute Walk Test ◽  
The Relationship ◽  
Minute Walk

This study investigated the mediating role of depressive symptoms among 147 middle-aged and older adults with FM in the relationship between pain intensity and 4 objective measures of physical performance: Fullerton Advanced Balance scale (FAB), 6-Minute Walk Test (6MWT), 30-Second Chair Stand (30SCS), and 8-Foot Up and Go Test (8FUPGT). Asymptotic mediation analyses revealed that depressive symptoms fully mediated the relationship between pain intensity and FAB (95% CI [−0.40, −0.10]) and 8FUPGT (CI [0.02, 0.11]) and partially mediated the relationship to 6MWT (CI [−9.15, −2.20]) and 30SCS (CI [−0.29, −0.06]). Findings support the evaluation of co-morbid depression in FM.

scholarly journals Inappropriate medications and physical function: a systematic review

2021 ◽  
Vol 12 ◽  
pp. 204209862110303
Author(s):  
Elizabeth Manias ◽  
Md Zunayed Kabir ◽  
Andrea B. Maier
Keyword(s):  
Older Adults ◽  
Physical Function ◽  
Physical Performance ◽  
Inappropriate Medication ◽  
Functional Independence ◽  
Potentially Inappropriate Medications ◽  
Timed Up And Go ◽  
Risk Of Falls ◽  
Prescribing Omissions ◽  
Inappropriate Medications

Background and aims: Inappropriate medication prescription is highly prevalent in older adults and is associated with adverse health outcomes. The aim of this study was to examine the associations between potentially inappropriate medications (PIMS) and potential prescribing omissions with physical function in older adults situated in diverse environments. Methods: A systematic search was completed using the following databases: MEDLINE, CINAHL, PsycINFO, EMBASE and COCHRANE. Results were extracted from the included studies. Results: In total, 55 studies reported on 2,767,594 participants with a mean age of 77.1 years (63.5% women). Study designs comprised 26 retrospective cohort studies, 21 prospective cohort studies and 8 cross-sectional studies. Inappropriate medications in community and hospital settings were significantly associated with higher risk of falls (21 out of 30 studies), higher risk of fractures (7 out of 9 studies), impaired activities of daily living (ADL; 8 out of 10 studies) and impaired instrumental ADL (IADL) score (4 out of 6 studies). Five out of seven studies also showed that PIMs were associated with poorer physical performance comprising the Timed Up and Go test, walking speed, grip strength, time to functional recovery, functional independence and scale of functioning. Many medication classes were implicated as PIMs in falls, fractures and impairment in physical performance including antipsychotic, sedative, anti-anxiety, anticholinergic, antidiabetic, opioid and antihypertensive medications. For patients not receiving musculoskeletal medications, such as calcium, vitamin D and bisphosphonates, older adults were found to be at risk of a hospital admission for a fall or fracture. Conclusion: Inappropriate medication prescriptions are associated with impaired physical function across longitudinal and cross-sectional studies in older adults situated in diverse settings. It is important to support older people to reduce their use of inappropriate medications and prevent prescribing omissions. Plain language summary Inappropriate medications and physical function Background and aims: The use of inappropriate medications is very common in older adults and is associated with harmful health problems. The aim was to examine associations between potentially inappropriate medications and potential prescribing omissions with physical function in older adults situated in diverse environments. Methods: Library databases were examined for possible studies to include and a systematic search was completed. Relevant information was obtained from the included studies. Results: In total, 55 studies reported on 2,767,594 participants who were an average age of 77.1 years and about 6 out of 10 were women. A variety of different study designs were used. Inappropriate medication prescriptions in community and hospital settings were significantly associated with higher risk of falls (21 out of 30 studies), higher risk of fractures (7 out of 9 studies), problems with activities of daily living (ADL), such as eating, bathing, dressing, grooming, walking and toileting (8 out of 10 studies) and problems with instrumental ADL such as managing medications, house cleaning and shopping (4 out of 6 studies). Five out of seven studies also showed that inappropriate medications were associated with poorer physical performance involving the Timed Up and Go test, walking speed, grip strength, time to functional recovery, functional independence and scale of functioning. Many types of medication classes were shown to be associated with a risk of falls, fractures and problems with physical performance. Omitted medications were also associated with falls and fractures. Conclusion: Inappropriate medication prescriptions are associated with problems relating to physical function. It is important to support older people to reduce their use of inappropriate medications and prevent prescribing omissions.

scholarly journals The impact of additional resistance and balance training in exercise-based cardiac rehabilitation in older patients after valve surgery or intervention: randomized control trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Egle Tamulevičiūtė-Prascienė ◽  
Aurelija Beigienė ◽  
Mark James Thompson ◽  
Kristina Balnė ◽  
Raimondas Kubilius ◽  
...  
Keyword(s):  
Cardiac Rehabilitation ◽  
Physical Performance ◽  
Older Patients ◽  
Balance Training ◽  
Valve Surgery ◽  
Walk Test ◽  
Physical Frailty ◽  
Additional Resistance ◽  
The Impact

Abstract Background To evaluate the short- and mid-term effect of a specially tailored resistance and balance training provided in addition to usual cardiac rehabilitation (CR) care program in older patients after valve surgery/intervention. Methods Single-center (inpatient CR clinic in Lithuania) randomized controlled trial. Two hundred fifty-two patients were assessed for eligibility on the first day of admittance to CR early after (14.5 ± 5.9 days) valve surgery/intervention between January 2018 and November 2019. Participants were coded centrally in accordance with randomization 1:1 using a computerized list. Control group (CG) patients were provided with usual care phase-II-CR inpatient multidisciplinary CR program, while intervention group (IG) patients received additional resistance and balance training (3 d/wk). Patients participated in a 3-month follow-up. Main outcome measures were functional capacity (6 min walk test (6MWT, meters), cardiopulmonary exercise testing), physical performance (Short Physical Performance Battery (SPPB, score) and 5-m walk test (5MWT, meters/second)), strength (one repetition maximum test for leg press), physical frailty (SPPB, 5MWT). Results One hundred sixteen patients (76.1 ± 6.7 years, 50% male) who fulfilled the study inclusion criteria were randomized to IG (n = 60) or CG (n = 56) and participated in CR (18.6 ± 2.7 days). As a result, 6MWT (IG 247 ± 94.1 vs. 348 ± 100.1, CG 232 ± 102.8 vs. 333 ± 120.7), SPPB (IG 8.31 ± 2.21 vs. 9.51 ± 2.24, CG 7.95 ± 2.01 vs. 9.08 ± 2.35), 5MWT (IG 0.847 ± 0.31 vs. 0.965 ± 0.3, CG 0.765 ± 0.24 vs 0.879 ± 0.29) all other outcome variables and physical frailty level improved significantly (p < 0.05) in both groups with no significant difference between groups. Improvements were sustained over the 3-month follow-up for 6MWT (IG 348 ± 113 vs. CG 332 ± 147.4), SPPB (IG 10.37 ± 1.59 vs CG 9.44 ± 2.34), 5MWT (IG 1.086 ± 0. 307 vs CG 1.123 ± 0.539) and other variables. Improvement in physical frailty level was significantly more pronounced in IG (p < 0.05) after the 3-month follow-up. Conclusion Exercise-based CR improves functional and exercise capacity, physical performance, and muscular strength, and reduces physical frailty levels in patients after valve surgery/intervention in the short and medium terms. SPPB score and 5MWT were useful for physical frailty assessment, screening and evaluation of outcomes in a CR setting. Additional benefit from the resistance and balance training could not be confirmed. Trial registration NCT04234087, retrospectively registered 21 January 2020.

scholarly journals Reliability and Responsiveness of Two Physical Performance Measures Examined in the Context of a Functional Training Intervention

2000 ◽  
Vol 80 (1) ◽  
pp. 8-16 ◽  
Author(s):  
Mary B King ◽  
James O Judge ◽  
Robert Whipple ◽  
Leslie Wolfson
Keyword(s):  
Physical Performance ◽  
Interrater Reliability ◽  
Intraclass Correlation ◽  
Intervention Group ◽  
Training Intervention ◽  
Control Group ◽  
Walk Test ◽  
Test Retest Reliability ◽  
6 Minute Walk Test ◽  
Minute Walk

Abstract Background and Purpose. The reliability and responsiveness of 2 physical performance measures were assessed in this nonrandomized, controlled pilot exercise intervention. Subjects. Forty-five older individuals with mobility impairment (mean age=77.9 years, SD=5.9, range=70–92) were sequentially assigned to participate in an exercise program (intervention group) or to a control group. Methods. The intervention group performed exercise 3 times a week for 12 weeks that targeted muscle force, endurance, balance, and flexibility. Outcome measures were the 8-item Physical Performance Test (PPT-8) and the 6-minute walk test. Test-retest reliability and responsiveness indexes were determined for both tests; interrater reliability was measured for the PPT-8. Results. The intraclass correlation coefficient for interrater reliability for the PPT-8 was .96. Intraclass correlation coefficients for test-retest reliability were .88 for the PPT-8 and .93 for the 6-minute walk test. The intervention group improved 2.4 points and the control group improved 0.7 point on the PPT-8, as compared with baseline measurements. There was no change in 6-minute walk test distance in the intervention group when compared with the control group. The responsiveness index was .8 for the PPT-8 and .6 for the 6-minute walk test. Conclusion and Discussion. Measurements for both the PPT-8 and the 6-minute walk test appeared to be highly reliable. The PPT-8 was more responsive than the 6-minute walk test to change in performance expected with this functional training intervention.

scholarly journals Updated national emission inventory and comparison with the Emissions Database for Global Atmospheric Research (EDGAR): case of Lebanon

2022 ◽  
Author(s):  
Anwar Al Shami ◽  
Elissar Al Aawar ◽  
Abdelkader Baayoun ◽  
Najat A. Saliba ◽  
Jonilda Kushta ◽  
...  
Keyword(s):  
Emission Inventory ◽  
Model Performance ◽  
Atmospheric Modeling ◽  
Atmospheric Pollutants ◽  
Pollutant Emissions ◽  
Emission Inventories ◽  
Gaseous Species ◽  
Emission Standard ◽  
Activity Data ◽  
Atmospheric Research

AbstractPhysically based computational modeling is an effective tool for estimating and predicting the spatial distribution of pollutant concentrations in complex environments. A detailed and up-to-date emission inventory is one of the most important components of atmospheric modeling and a prerequisite for achieving high model performance. Lebanon lacks an accurate inventory of anthropogenic emission fluxes. In the absence of a clear emission standard and standardized activity datasets in Lebanon, this work serves to fill this gap by presenting the first national effort to develop a national emission inventory by exhaustively quantifying detailed multisector, multi-species pollutant emissions in Lebanon for atmospheric pollutants that are internationally monitored and regulated as relevant to air quality. Following the classification of the Emissions Database for Global Atmospheric Research (EDGAR), we present the methodology followed for each subsector based on its characteristics and types of fuels consumed. The estimated emissions encompass gaseous species (CO, NOx, SO2), and particulate matter (PM2.5 and PM10). We compare totals per sector obtained from the newly developed national inventory with the international EDGAR inventory and previously published emission inventories for the country for base year 2010 presenting current discrepancies and analyzing their causes. The observed discrepancies highlight the fact that emission inventories, especially for data-scarce settings, are highly sensitive to the activity data and their underlying assumptions, and to the methodology used to estimate the emissions.

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