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JFSF 2020

Review Article JFSF, Vol 5, No 1, March 2020, p.1-5
Dietary protein intake and bone health
Amalia Tsagari
Keywords: Bone biomarkers, Bone health, Bone mineral density, Dietary protein
Abstract
Considerable attention has recently focused on dietary protein’s role in the mature skeleton. The aim was to conduct a systematic review evaluating the effects of dietary protein intake alone on bone health measures in adults (Bone Mineral Density (BMD) and bone biomarkers. Searches across 3 databases were conducted through February 2019 including randomized controlled trials (RCT’s) and prospective cohort studies examining the effects of "high versus low" protein intake. Studies in various populations are currently limited, varying doses and dietary compositions were used or prescribed, respectively, and there was medium risk of bias among the RCTs and the cohort studies examined. Moderate evidence suggested that higher protein intake may have protective effect on lumbar spine (LS) bone mineral density (BMD) compared with lower protein intake but no effect on total hip (TH), femoral neck (FN), or total body BMD or bone biomarkers. Current evidence shows no adv erse effects of higher protein intakes. Although there were positive trends on BMD at most bone cites, only the LS showed moderate evidence to support benefits of higher protein intake. Studies were heterogeneous. High-quality, long-term studies are needed to clarify dietary protein’s role in bone health.
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Original Article JFSF, Vol 5, No 1, March 2020, p.6-9
Mission (im)possible: Engaging care homes, staff and residents in research studies
Maria Giné-Garriga, Marlene Sandlund, Javier Jerez-Roig, Jo Booth, Dawn A. Skelton
Keywords: Care home setting, Older adults, Research engagement, Staff perceptions
Abstract
Objectives: With increasing age the risk of institutionalization increases. To address the problem of underrepresentation of care homes and their residents in future research studies, we aimed to explore care home staff members’ thoughts on barriers, challenges, facilitators and key aspects of engaging in research studies. Methods: Five staff members from four care homes in Glasgow and Barcelona were interviewed. Transcription of the interviews was completed verbatim and an inductive thematic analysis was conducted to understand the difficulties and challenges they perceive for engaging in research studies. Results: Three themes emerged that encapsulated the staff members’ perspectives. ‘Too much to deal with’ included two subthemes; ‘interested but with support’ encapsulated four subthemes; and ‘on the residents’ terms’ highlighted three subthemes. Staff members showed interest in engaging in research studies if a clear management support accompanied by a whole team approach was evident. The involvement of the resident’s relatives was seen as essential if residents were to be supported to be engaged. Conclusions: Despite the small sample size, the perspectives of staff members, irrespective of country, provided valuable insights for informing researchers on best approaches to maximize care home and resident engagement in research.
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Research Protocol JFSF, Vol 5, No 1, March 2020, p.10-16
Enhancing existing formal home care to improve and maintain functional status in older adults: Protocol for a feasibility study on the implementation of the Care to Move (CTM) programme in an Irish healthcare setting
N. Frances Horgan, Vanda Cummins, Frank Doyle, Maria O’Sullivan, Rose Galvin, Elissa Burton, Jan Sorensen, Dawn A. Skelton, Bex Townley, Debbie Rooney, Gill Jackson, Lauren Swan, Austin Warters
Keywords: Community-dwelling, Feasibility, Home care, Older person, Physical activity-based
Abstract
An increasing ageing population leads to greater demand for care services to help maintain people in their own homes. Physical activity programmes have been shown to improve older adults’ functional capacity, enabling the older adult to live independently and maintain functional status. There has been a lack of quality research conducted around physical activity within the landscape of home care services. We describe a feasibility study of implementing the Care to Move (CTM) programme in older adults receiving low-level home care. A Phase 1 mixed-methods feasibility study design will explore the recruitment, attrition, retention, costs to deliver and data loss. It will also explore the acceptability and impact of the CTM programme on older adults and thematic analysis of data collected from older people, home care workers and relevant stakeholders through use of semi-structured interviews and focus groups. We will measure functional status and fall outcomes in older adults receiving low levels of home care, facilitating this population to continue living independently at home and providing data currently not known around this group.
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Original Article JFSF, Vol 5, No 1, March 2020, p.17-23
Content of exercise programmes targeting older people with sarcopenia or frailty – findings from a UK survey
Miles D. Witham, Melody Chawner, Sarah De Biase, Natalie Offord, Oliver Todd, Andrew Clegg, Avan A. Sayer
Keywords: Exercise, Frailty, Resistance training, Sarcopenia, Survey
Abstract
Objectives: To establish whether existing exercise programmes offered to people with sarcopenia or frailty adhere to the current evidence base. Methods: We conducted a national survey of practitioners delivering exercise programmes to older people with sarcopenia or frailty in the UK. The link to the online survey was distributed through email lists of professional societies, practice networks and social media. Questions covered target population and programme aims, type, duration and frequency of exercise, progress assessment and outcome measures. Results: One hundred and thirty-six responses were received. 94% of respondents reported prescribing or delivering exercise programmes to people with sarcopenia or frailty. Most programmes (81/135 [60%]) were primarily designed to prevent or reduce falls. Resistance training was the main focus in only 11/123 (9%), balance training in 61/123 (50%) and functional exercise in 28/123 (23%). Exercise was offered once a week or less by 81/124 (65%) of respondents. Outcome measures suitable for assessing the effect of resistance training programmes were reported by fewer than half of respondents (hand grip: 13/119 [11%]; chair stands: 55/119 [46%]). Conclusions: Current UK exercise programmes offered to older people with sarcopenia or frailty lack the specificity, frequency or duration of exercise likely to improve outcomes for this patient group.
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Original Article JFSF, Vol 5, No 2, June 2020, p.24-30
Neither Timed Up and Go test nor Short Physical Performance Battery predict future falls among independent adults aged ≥75 years living in the community
Beatrice Pettersson, Ellinor Nordin, Anna Ramnemark, Lillemor Lundin-Olsson
Keywords: Accidental falls, Aged, Functional ability, Geriatric assessment/methods, Postural balance
Abstract
Objectives: Previous research has shown that balance and gait difficulties are predictors of falls. The aim of this study was to evaluate the predictive validity of two tools reporting on balance and gait among older community living adults independent in personal activities of daily living (p-ADL). Methods: Prospective study design. Baseline assessment included the Timed Up and Go test (TUG) and the Short Physical Performance Battery (SPPB). Following baseline, falls were recorded monthly for one year by 202 participants (70.1% women) who were independent in p-ADL, and at least 75 years old (79.2±3.5). ROC-curves were made and AUC were calculated. Results: Fortyseven percent of the participants reported falls. AUCs calculated for TUG were 0.5 (95% CI: 0.5-0.6) for those with at least one fall, and 0.5 (95% CI: 0.5-0.6) for recurrent fallers. Corresponding figures for SPPB were 0.5 (95% CI: 0.5-0.6) and 0.5 (95% CI: 0.5-0.6). Conclusion: This study does not support a recommendation to use the Timed Up and Go test or the Short Physical Performance Battery as tools for the identification of fall-prone persons among older adults living in the community. These results reinforce the need for further research into appropriate tools for identifying independent but fall-prone older adults.
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Review Article JFSF, Vol 5, No 2, June 2020, p.31-37
Dual-task exercises in older adults: A structured review of current literature
Luz A. Varela-Vásquez, Eduard Minobes-Molina, Javier Jerez-Roig
Keywords: Ageing, Balance, Dual task, Risk of falling, Walking speed
Abstract
Considerable attention has recently focused on the role of dual-task exercises (DT) in the older adult. The aim was to conduct a review to describe the dual-task exercises that have been shown to be effective in improving balance and other physical characteristics such as decreased falling and walking speed in older adults. Review of intervention studies, in the Pubmed, PEDro, CINAHL and Web of Science databases. The search produced 498 references, 11 of which were identified with the description of the dual-task exercises, finding a wide variety of exercises, as well as great variability of outcome measures, discovering that the dual task is predominantly used for balance and walking speed training. All studies presented at least one group performing a double cognitive-motor task, some studies used the fixed priority modality in one group and variable in another, finding greater improvements in variable prioritisation. It can be said that dual-task training in older adults can improve balance and walking speed, which in turn reduces the risk of falling only if the planned dual-task training meets certain characteristics, such as training in specific concepts crucial in motor learning and dual-task training modalities.
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Opinion Article JFSF, Vol 5, No 2, June 2020, p.38-41
Sarcopenia in Hemiplegia
Maria C. Papadatou
Keywords: Disability, Muscle strength, Muscle wasting, Sarcopenia, Stroke
Abstract
Sarcopenia is a disease characterized by quantitative and qualitative degeneration of the skeletal muscles and it primarily presents with a decline in the muscle strength. It frequently occurs in patients after a cerebrovascular accident due to a combination of various factors, such as the brain injury, structural adaptations, limited physical activity as long as malnutrition. Most of the articles and reviews concerning stroke-related sarcopenia are limited and usually are discussing about the factors and causes that may lead to the muscle wasting and the particular characteristics that distinguish it from age-related sarcopenia. As a result, even though sarcopenia is described as a medical entity, it appears to lack the attention that requires, limiting the maximum therapeutic effect a patient can obtain. Suggestions have been made concerning general treatment and management of sarcopenia, associated with exercise, diet and the use of medical preparations, lacking though disease-specific guidelines for management, treatment and possibly prevention of stroke-related sarcopenia. Nowadays, it is considered of major importance that the medical community should be properly informed and to raise awareness on this particular issue aiming to a better and holistic management of the patients after a cerebrovascular accident, in order to reduce morbidity and disability that both are sequelae that reduce quality of life.
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Short Communication JFSF, Vol 5, No 2, June 2020, p.42-46
The MOVE.TE Falls Prevention and Management Program: lessons learnt in the Portuguese context
Pedro Maciel Barbosa, Anabela C. Martins, Paula C. Santos, Ricardo Dias, Paulo Pereira, Bernardo Pinto, Rubina Moniz, Ana C. Casaca, Rita Silva, Cristina Melo, Ana L. Silva, Maria J. Bigode, Hugo Mendes, Madalena Gomes da Silva
Keywords: Falls prevention, Physiotherapy, Older Adults, Knowledge Translation
Abstract
MOVE.TE is a non-profit participatory physiotherapy platform that aims at translating knowledge in the field of physiotherapy and developing freely available evidence-based physiotherapy programmes targeting the primary care services of the Portuguese National Health service. A group of volunteer academics and clinicians collaborated at different stages and time points to create the first ever falls prevention and management programme and guidance for Physiotherapy in primary care, in Portugal. This report describes this seven-step process. In spite of many challenges, this project constitutes an example of advocacy in physiotherapy for the promotion of better healthcare for older adults.
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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
Abstract
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.
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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
Abstract
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.
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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
Abstract
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.
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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
Abstract
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.
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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
Abstract
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.
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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
Abstract
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.
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Opinion Article JFSF, Vol 5, No 4, December 2020, p.86-88
It’s Corona Calling: Time for Telerehabilitation!
Marcalee Alexander
Keywords: Climate change, Covid-19, Disability, Sustain our abilities, Telerehabilitation
Abstract
The Covid-19 pandemic has caused a disproportionate impact on people with disabilities and the elderly. Moreover, the pandemic can be likened to disasters caused by catastrophic weather events which will increase in the future in response to climate change. To forestall these threats, rehabilitation professionals must to come together internationally to prepare and proactively educate their peers and patients. This can be done through observance of such times as Day for Tomorrow. Moreover, rehabilitation professionals need to transition to greener forms of healthcare in order to assure that in the future we all sustain our abilities.
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Opinion Article JFSF, Vol 5, No 4, December 2020, p.89-91
Proposals for continued research to determine older adults’ falls risk
Beatrice Pettersson, Ellinor Nordin, Anna Ramnemark, Lillemor Lundin-Olsson
Keywords: Accidental falls, Aged, Functional ability, Geriatric assessment/methods, Postural balance
Abstract
Early detection of older adults with an increased risk of falling could enable early onset of preventative measures. Currently used fall risk assessment tools have not proven sufficiently effective in differentiating between high and low fall risk in community-living older adults. There are a number of tests and measures available, but many timed and observation-based tools are performed on a flat floor without interaction with the surrounding. To improve falls prediction, measurements in other areas that challenge mobility in dynamic conditions and that take a persons’ own perception of steadiness into account should be further developed and evaluated as single or combined measures. The tools should be easy to apply in clinical practice or used as a self-assessment by the older adults themselves.
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Original Article JFSF, Vol 5, No 4, December 2020, p.92-101
Frailty Syndrome among oldest old Individuals, aged ≥80 years: Prevalence & Correlates
Pawan Kumar Sharma, Bana Manishaa Reddy, Enakshi Ganguly
Keywords: COPD, Depression, Frailty, Hypertension, Oldest old
Abstract
Objectives: Objectives were to study prevalence of frailty among Indian oldest old population, and to detect its correlates. Methods: A cross sectional community based study was done including 200 healthy participants aged ≥80 years, randomly sampled from Hyderabad city in India. They completed an administered questionnaire and physical function tests including SPPB, grip strength. Cognitive function was assessed using MMSE and depression using GDS. Blood pressure, haemoglobin, and fasting blood sugar were measured for all participants. Frailty was defined using Fried phenotype criteria. Logistic regression was done to identify independently associated correlates. Results: The prevalence of frailty syndrome was 83.4% in our study population. Frailty among men was 80.3% and among women was 84.7%, and it increased with increasing age. The independent correlates which increased the odds of frailty were poor physical performance (SPPB) (OR: 4.21; 95%CI: 1.12-15.83), depression (OR: 3.35; 95%CI:1.29-8.73), chronic joint pains (OR:4.90; 95%CI: 1.97-12.18) and COPD (OR: 3.01; 95%CI:1.03- 8.78), while hypertension showed inverse association (OR: 0.33;95%CI:0.11-0.94). Conclusion: The prevalence of frailty among the oldest old is very high. Geriatric medicine protocols must include routine screening for frailty, while also including early detection of poor physical performance, depression, COPD and osteoarthritis.
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Original Article JFSF, Vol 5, No 4, December 2020, p.102-108
Are the group-based interventions improving the functional exercise capacity and quality of life of frail subjects with chronic heart failure?
Jannis Vasileios Papathanasiou
Keywords: Chronic heart failure, Frailty, Group-based, Rehabilitation
Abstract
Objectives: Frail subjects with chronic heart failure (CHF) often demonstrate limited tolerance of exertion, shortness of breath, and reduced walking capacity resulting poor quality of life (QoL). The aim of this study was to quantify the improvements in functional exercise capacity (FEC) and QoL among Bulgarian frail subjects with CHF performed group-based high-intensity aerobic interval training (HIAIT)/m-Ullevaal intervention and to compare it with moderate intensity continuous training (MICT) protocol. Methods: One hundred and twenty (n=120) frail subjects with mean age of 63.73±6.68 years, in CHF and NYHA class II-IIIB, were enrolled in the single-center, prospective, two-arm randomized controlled clinical trial conducted at the Medical Center for Rehabilitation and Sports Medicine-I-Plovdiv. The baseline assessment included 6-minute walk test (6ΜWT), peak oxygen uptake (VO2peak), modified Borg Perceived Exertion Scale (mBPES), and Minnesota living with the Heart Failure Questionnaire (MLHFQ). Results: The improvement in 6MWT (P<0.001), VO2peak (P<0.001), mBPES (P<0.001), and MLHFQ (P<0.001) observed among frail subjects performed HIAIT/m-Ullevaal intervention was significantly greater compared to the improvement observed in the subjects performed MICT protocol (P<0.001). Conclusions: The group-based HIAIT/m-Ullevaal intervention is a new perspective and challenge for both, Bulgarian cardiac rehabilitation (CR), and frail patients with CHF.
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Short Communication JFSF, Vol 5, No 4, December 2020, p.109-113
What is most appropriate number of repetitions of the sit-to-stand test in older adults: a reliability study
Maria Tsekoura, Konstantinos Anastasopoulos, Alexandros Kastrinis, Zacharias Dimitriadis
Keywords: Older adults, Reliability, Sit to stand test
Abstract
The most frequently employed versions of the sit-to-stand test (STST) are the 5 times STSΤ and the 30 seconds STST. However, it is not known whether a variation with different number of repetitions or time could be more appropriate for older adults. The objective of this study was to investigate the reliability of STST at different time points and number of repetitions. The test was performed in 33 older adults (73±6.1 years) for 40 seconds. The participants performed the procedure twice with a day interval between the sessions. The test was video-taped and the data were processed by two examiners. The highest test-retest reliability was found for the 4th (ICC=0.73, SEM=1.48, SDD=1.68), 5th (ICC=0.76, SEM=1.73, SDD=1.97) and 6th repetition (ICC=0.78, SEM=1.78, SDD=2.03). The inter-rater reliability was excellent independently of the number of trials (ICC>0.9). The correlation of the time at the 4th and 6th repetition with the time at the traditionally selected 5th repetition was excellent (r>0.9). The termination of the STST at the 4th repetition seems to provide equally reliable and valid estimations with the termination at the 5th repetition. Future studies should examine a 4 times STST since the reduction of the number of repetitions may be less tiring and safer for older adults.
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