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Volume 5, Issue 3, September 2020

Original Article JFSF, Vol 5, No 3, September 2020, p.47-52
Feasibility of a novel Judo4Balance – fall preventive exercise programme targeting community-dwelling older adults
Marina Arkkukangas, Karin Strömqvist Bååthe, Julia Hamilton, Anna Ekholm, Michail Tonkonogi
Keywords: Older adults, Exercise, Fall accidents, Fall injury, Self-efficacy
Objectives: It is of utmost importance to investigate risk factors for falls and learning techniques for falling safely. Therefore, the aim of this study was to assess the feasibility of a novel judo-inspired exercise intervention for community-dwelling older adults. Methods: We included 28 participants, 60–88 years of age, in this study. In three different settings, the feasibility of carrying out a full-scale study was evaluated by the following: the study process, resource management and scientific aspects. The outcome measures evaluated were physical performance, fall related self-efficacy and fall techniques (backwards and forwards) among the older adults. Results: The intervention was judged to be feasible in the different settings used in this study. Some changes regarding duration of the intervention were suggested as being important. Significant improvements were seen in the selected outcome measures, physical performance (p=.030) and fall techniques (p=<.001). A corresponding difference was not found for fall related self- efficacy (p=.113). Conclusions: This study confirms the judo inspired exercise programme, Judo4Balance, to be a feasible intervention for active older adults. This study will provide a safe and thoroughly planned protocol for the planned study and provides indication of appropriate setting depending on the target group.
Original Article JFSF, Vol 5, No 3, September 2020, p.53-56
Prevalence of sarcopenia in pre-frail community dwelling older adult and utility of SARC-F, SARC-CalF and calf circumference in case finding
Jia Yi Lim, Nethania Ann Low, Reshma Aziz Merchant
Keywords: Sarcopenia, Calf circumference, AWGS 2019, Case finding, Pre-frail
Objective: To determine the prevalence of sarcopenia in the pre-frail community dwelling older adults based on the Asian Workgroup for Sarcopenia (AWGS 2019) criteria. In addition, the utility of case finding using the SARC-F, SARC-CalF and calf circumference on impact of prevalence was explored. Methods: 75 older adults ≥65 years old were recruited between October 2019 and March 2020. The algorithms of AWGS 2019 was applied retrospectively to pre-frail participants recruited for an intervention study in primary care setting. In addition to demographics, SARC-F, calf circumference (CC), muscle mass, grip strength, gait speed, 5-time chair stand timing and short physical performance battery test (SPPB) were measured, to determine sarcopenia using AWGS 2019. SARC-CalF was determined using SARC-F and CC. Results: The prevalence of sarcopenia based on AWGS 2019 algorithm was 16.0%, possible sarcopenia 73.3% and severe sarcopenia 12.0%. Using SARC-F for case finding reduced the overall prevalence of sarcopenia to 4.0%, possible sarcopenia to 12.0% and severe sarcopenia to 4.0%. Positive percentage agreement of case finding criteria of SARC-F, SARC-CaIF and calf circumference for sarcopenia was 33%, 42% and 58% respectively. Conclusions: Using the AWGS 2019 without case finding, the prevalence of sarcopenia was 16%. However, using SARC-F for case finding underestimated prevalence in this group by 75%. Utility of SARC-F for case finding in pre-frail requires further evaluation.
Mini Review JFSF, Vol 5, No 3, September 2020, p.57-61
Frailty assessment and postoperative complications in urologic oncology operations
Nikolaos A. Kostakopoulos, Nikolaos D. Karakousis
Keywords: Frailty, Frailty calculator, Frailty index, Postoperative complications, Urologic oncology operations
Major urologic oncology procedures such as radical cystectomy (RC), radical prostatectomy (RP), radical nephroureterectomy (RNU) and radical or partial nephrectomy are the gold standard operations for the treatment of urological malignancies not suitable to be dealt with using minimal invasive procedures such as transurethral resection or other conservative approaches. However, these surgical procedures carry significant risk of complications, especially in elderly and frail patients. The purpose of this review is to highlight the use of a wide variety of preoperative frailty and health status indexes and calculators. Recent data from large population based studies confirm that these calculators can assist physicians and urologists to predict the postoperative morbidity of patients undergoing major operations. Moreover, these frailty calculators can help urologists choose the most suitable and safe treatment for every individual patient. However, the absence of widely accepted specific urologic oncology calculators to predict the association between frailty and postoperative complications emphasizes the necessity for the use of a combination of calculators.
Original Article JFSF, Vol 5, No 3, September 2020, p.62-71
The prevalence of cognitive frailty and pre-frailty among older people in Bangkok metropolitan area: a multicenter study of hospital-based outpatient clinics
Panuwat Wongtrakulruang, Weerasak Muangpaisan, Bubpha Panpradup, Aree Tawatwattananun, Monchai Siribamrungwong, Sasinapha Tomongkon
Keywords: Cognitive frailty, Dementia, Frailty, Mild cognitive impairment, Pre-frailty
Objectives: To identify the prevalence of, and factors associated with, cognitive frailty and prefrailty, and to investigate correlation between frailty tools. Methods: One hundred and ninety five older adults were recruited from the medical outpatient clinics of 3 tertiary hospitals in Bangkok metropolitan region. The data collected were demographic information, lifestyle factors, functional status, mood assessment, and cognitive and frailty assessments. The frailty tools used were Frailty Phenotype and FRAIL scale. Results: The prevalence of pre-frailty, frailty, mild cognitive impairment (MCI), cognitive pre-frailty and cognitive frailty was 57.4%, 15.9%, 26.2%, 14.4% and 6.7%, respectively. A multivariate analysis showed that age ≥70 years (OR 5.34; 95% CI 2.06-12.63), and education at primary school or under (OR 4.18; 95% CI 1.61-10.82) were associated with cognitive frailty and cognitive pre-frailty. The correlation between physical frailty rated by the Modified Fried Frailty Phenotype and the FRAIL scale was good (Kappa coefficient = 0.741). Conclusions: The prevalence of cognitive frailty is not uncommon which requires screening and interventions. Age and a low educational level were related to cognitive frailty/prefrailty. The FRAIL scale yielded a high correlation with Frailty phenotypes, implying its benefit in routine clinical use in primary care practice, where there is limited time and resources.
Original Article JFSF, Vol 5, No 3, September 2020, p.72-78
Disease-related factors associated with exercise adherence in postmenopausal women with osteoporosis
Salvador Israel Macías-Hernández, Florentina Loya-García, Rafael Zepeda-Mora, Tania Inés Nava-Bringas, Juan Daniel Morones-Alba
Keywords: Exercise, Osteoporosis, Postmenopausal, Postural balance, Therapeutic adherence
Objectives: Exercise is the most widely-used intervention for reducing bone loss and the incidence of falls and fractures in osteoporosis patients. However, disease-related changes can alter these patients’ adherence to exercise programs. This study attempted to describe the factors influencing exercise adherence in a group of postmenopausal women with osteoporosis. Methods: We conducted a retrospective cohort of postmenopausal women with osteoporosis. We collected data from each patient’s last clinical evaluation, as well as from their clinical file of the previous year. Results: A total of 288 women were included in the study, with an average age of 69.45 (Standard deviation ± 9.2 years). Around a quarter, 76 (26.3%), of the patients did not adhere to exercise, 91 (31.5%) did partially, and 121 (41.9%) did completely. In univariate analysis, the variables significantly associated with exercise adherence were age, height, spine pain intensity, joint pain, and prevalent fracture. In a logistic regression model, pharmacological treatment for osteoporosis and polypharmacy were associated with exercise adherence, while poor balance and hyperkyphosis were associated with non-adherence. Conclusion: Pharmacological treatment, polypharmacy, poor balance, and hyperkyphosis all appear to be associated with exercise adherence. As these findings are the significant predictors of exercise engagement, it is necessary to explore balance and postural changes and emphasize the importance of postural and balance training prescription in this group of patients.
Original Article JFSF, Vol 5, No 3, September 2020, p.79-85
Prevalence and associated factors of sarcopenia among patients underwent abdominal CT scan in Tertiary Care Hospital of South India
Pankajakshan Rema Sreepriya, Shikha Sivasankara Pillai, Anjana Nalina Kumari Kesavan Nair, Arya Rahul, Sandeep Pillai, Anish Thekkumkara Surendran Nair
Keywords: Computerized tomography, Lumbar skeletal muscle index, Predictors of sarcopenia, Prevalence of sarcopenia, Sarcopenia among Indians
Objective: To estimate the proportion of radiologically significant (LSMI) sarcopenia and the factors associated with it among patients undergoing Computerized Tomography scan. Methods: A Cross sectional study was conducted among 152 patients underwent CT scan in the radiology department of Government medical college Thiruvananthapuram. Sarcopenia was estimated based on lumbar skeletal muscle index obtained using cross sectional areas of various abdominal muscles by CT scan. The proportion of sarcopenia was estimated and associated factors studied. Binary logistic regression model was used to adjust the confounders. Results: Out of 152 individuals, sarcopenia was present in a total of 82 (53.95%) individuals. Male gender (Adjusted OR= 8.42, 3.64 - 19.52 (95% CI)) was a risk factor for and a body mass index more than 25Kg/m2 (Adjusted OR= 0.36, 0.15- 0.67 (95% CI)) was a protective factor against sarcopenia. Conclusion: The burden of sarcopenia is found to be high and considering the double burden of sarcopenia and obesity in the Kerala community, newer strategies for health promotion and early detection need to be developed.