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Volume 8, Issue 3, September 2023

Original Article JFSF, Vol 8, No 3, September 2023, p.139-147
Older Hospitalised Patients' Reported Confidence in Managing Discharge Needs: A Retrospective Observational Study
Peter Hartley, Olivia Sharpe, Roman Romero-Ortuno
Keywords: Aged, Confidence, Hospital, Patient Reported Outcome Measure
Objectives: To evaluate the introduction of a patient-reported outcome measure (PROM) of self-confidence in managing discharge needs in an acutely hospitalised older adult population. Methods: A retrospective service evaluation in an English hospital. The PROM measure consisted of a visual analogue scale asking patients to rate their confidence with managing the things that they would need to do at home. This was collected on admission and discharge. Results: Of 923 patients, 461 had both admission and discharge confidence scores. Median confidence was higher at discharge (8.00, IQR: 6.20-9.80) than on admission (7.20, 5.00-9.00) (P<0.001). Predictors of high confidence with managing discharge needs at admission were: being male; having a lower number of morbidities; self-reporting fewer falls over the last year; and a higher level of functional mobility. Low confidence score on admission, being from one's own home, and a higher number of physiotherapy contacts were associated with improvement in PROM scores. Self-confidence in managing discharge needs at discharge was not associated with readmission within 30 days. Conclusions: Measuring patient-reported confidence to manage discharge needs is feasible in an older inpatient population. Confidence improved from admission to discharge, and more frequent physiotherapy input was associated with improved confidence.
Original Article JFSF, Vol 8, No 3, September 2023, p.148-154
Do low levels of alanine aminotransferase, a baseline marker of sarcopenia and frailty, associate with worse clinical outcomes among hospitalized COVID-19 patients? A Retrospective Cohort Study
Ehud Raz Gatt, Eyal Zilber, Max Perelman, Nitsan Landau, Maya Yakir, Noam Glick, Liat Negru, Gad Segal, Edward Itelman
Keywords: ALT, Clinical outcomes, Corona virus, Frailty, Sacrcopenia
Objectives: COVID-19 geoperdize lives. Not all the risk factors for negative outcomes are known. Sarcopenia and frailty are common, negatively affecting clinical outcomes. Studies have shown that sarcopenia and frailty are associated with worse outcomes. Our objective was to examine whether low ALT (Alanine-aminotranferase), a surrogate marker for sarcopenia, is associated with worse clinical outcomes among hospitalized COVID-19 patients. Methods: We reviewed cases of COVID-19 in a tertiary hospital, during three COVID-19 waves and examined correlations between ALT and mortality using crude, univariate and multivariate analysis for age, gender, hypertension, Chronic obstructive pulmonary disease and Congestive heart failure. Results: 357 patients were included in this analysis. Median age was 69, 54% were males. Median ALT was 19 IU/L. During follow-up, 73 (20%) died. Patients with low ALT were more likely to die (HR 1.82, 95% CI 1.06-3.09, P=0.028). Other predictors for mortality were low albumin, background COPD, dyslipidemia, dementia, and malignancy. The multivariate analysis showed that low ALT was still an independent predictor of poor prognosis (HR 1.7, 95% CI 1.0-2.9, P=0.049). Conclusions: In our analysis of COVID-19 patients, low ALT levels were independently associated with increased risk of mortality, both as standalone and when incorporated into a multivariate analysis.
Original Article JFSF, Vol 8, No 3, September 2023, p.155-162
The relationship between quadriceps femoris thickness measured by US and femoral cartilage thickness in knee osteoarthritis, its effect on radiographic stage and clinical parameters: comparison with healthy young population
Ahmet Bozan, Belgin Erhan
Keywords: Cartilge thickness, Knee osteoarthritis, Quadriceps muscule thickness, US
Objective: In this study, we aimed to investigate the relationship between quadriceps muscle thickness and femoral cartilage thickness measured by ultrasonography (US) in knee osteoarthritis (OA), to correlate this relationship with radiographic stage and clinical parameters, and to compare these values with those in healthy young adults. Methods: A total of 71 patients with knee osteoarthritis and 31 healthy young adults were included in the study. Patients with knee osteoarthritis (Group 1) and healthy young adults (Group 2) were divided into two groups. Muscle thickness measurements of the quadriceps femoris muscle (M. vastus intermedius + M. rectus femoris) were performed by US. Results: Bilateral quadriceps muscle thickness and bilateral femoral cartilage thickness values were significantly lower in Group 1 than in Group 2. The 10-metre walk test score and Time Up and Go (TUG) test score were significantly higher in Group 1 than in Group 2. A strong positive correlation was found between bilateral quadriceps (RF+VI) muscle thickness and bilateral femoral cartilage thickness (medial, intercondylar, lateral) in Group 1. Conclusions: This study showed a strong positive correlation between quadriceps thickness and femoral cartilage thickness. According to these results, we conclude that US may have a place in the diagnosis of knee osteoarthritis.
Original Article JFSF, Vol 8, No 3, September 2023, p.163-173
Superimposed electromyostimulation of the thigh muscles during passive isokinetic cycling increases muscle strength without effort
Kazuyuki Ogiso, Takuto Horasawa
Keywords: Electromyostimulation, Kinesthesia, Muscle Strength, Passive Isokinetic Cycle Exercise, Sarcopenia Prevention
Objectives: This study was designed to investigate the effects of a completely passive isokinetic cycle (PIC) exercise with electromyostimulation (EMS) on improving muscle strength and the changes in kinesthesia during daily activities. Methods: Twenty-nine sedentary females were divided into three groups. The EMS anterior and whole groups performed the PIC exercise without EMS 3 times a week for 3 weeks, followed by a 1-week break, and then performed it with EMS applied to the anterior and entire thigh muscles, respectively, 3 times a week for 3 weeks. The control group did not perform any training. Results: The PIC exercise with EMS significantly increased the 30s chair stand test scores by 12-16% and the maximum isometric knee extension and flexion torques by 38-68% in both EMS-applied groups. The participants found its exercise easy and felt more comfortable with daily physical activities. The exercise without EMS did not show similar improvements. Muscle soreness was significantly greater in the EMS anterior group than in the EMS whole group; however, it was not severe. Conclusions: The PIC exercise with EMS resulted in significant increases in muscle strength, facilitating a perceived ease of daily physical activities, while minimizing difficulties, effort, and notable muscle soreness.
Review Article JFSF, Vol 8, No 3, September 2023, p.174-187
Does stretching of anterior structures alone, or in combination with strengthening of posterior structures, decrease hyperkyphosis and improve posture in adults? A Systematic Review and Meta-analysis
Rebecca A. Withers, C. Ryanne Plesh, Dawn A. Skelton
Keywords: Adults, Exercise, Hyperkyphosis, Posture, Stretching
Kyphosis can lead to back pain, poor posture, and increased falls risk. This systematic review aimed to synthesize research on stretching alone, or in combination with strengthening, as a management for hyperkyphosis in the adult population (≥18 years old). An electronic database search was conducted from February to March 2022. The author and an independent reviewer screened titles and abstracts for inclusion criteria - those whose intervention involved stretching alone or with strengthening exercises. The author appraised and extracted data from included articles and performed a meta-analysis where appropriate. The database and citation search yielded 327 articles, 18 of which met inclusion criteria. One study included performed stretching as a standalone intervention; the remainder used a combination of stretching and strengthening. The meta-analysis (n=3, with 5 exercise groups) found a statistically significant difference (MD = -6.97 (95% CI -9.84, -4.10), p<0.00001) in post-intervention measures of hyperkyphosis favouring the exercise group. The narrative review of studies agrees with this finding, demonstrating statistically significant improvement in hyperkyphosis following various exercise programs. This review suggests that stretching and strengthening exercises improve hyperkyphosis in the short and long term. Low-quality evidence supports stretching as a standalone intervention. Further, more robust research is required to recommend procedures and determine if stretching alone is effective for treating hyperkyphosis in adults.
Review Article JFSF, Vol 8, No 3, September 2023, p.188-194
Resistance Training in Post-COVID Recovery: Rationale and Current Evidence
George Mills, Enya Daynes, Hamish J.C. McAuley, Neil J. Greening, Samuel Briggs-Price, Molly M. Baldwin, Sally J. Singh
Keywords: COVID-19, Exercise, Muscle, Resistance training, Rehabilitation
During hospitalisation with COVID-19, individuals may experience prolonged periods of immobilisation. Combined with the inflammatory effects of the virus, this may lead to a significant reduction in both muscle mass and strength. Data from several long-term studies suggest that these symptoms may not fully resolve within one year. Owing to its effectiveness at inducing muscle fibre hypertrophy and improving neuromuscular efficiency, resistance training is of great interest in the rehabilitation of this population. This narrative review aims to identify the rationale and potential efficacy of resistance training for restoring physical function following infection with SARS-CoV-2, as well as evidence of its use in clinical practice. The studies included in this narrative review consisted mostly of multi-component rehabilitation trials. Of these, widespread improvements in muscle strength were reported using intensities of up to 80% of participants' 1-repetition-maximum. Evidence thus far indicates that resistance training may be safe and effective in patients following COVID-19, although its individual contribution is difficult to discern. Future exercise intervention studies investigating the efficacy of resistance training as a sole modality are needed.
Short Communication JFSF, Vol 8, No 3, September 2023, p.195-199
Turkish version of the SHARE-Frailty Instrument for primary care: reliability and validity in the nursing home setting
Gülendam Hakverdioğlu Yönt, Román Romero Ortuño, Fisun Şenuzun Aykar, Duygu İlbay
Keywords: Care dependency, Frailty, Geriatric care, Nursing home, Validation studies
In Turkey, physical frailty instruments have not been studied in the nursing home setting. We determined the reliability and validity of a Turkish version of the SHARE-Frailty Instrument for primary care (SHARE-FI) in Turkish nursing home residents. Cronbach's alpha reliability analysis was performed to determine internal consistency. Factor analysis was conducted to explore construct validity. Concurrent validity was assessed by correlation with the Care Dependency Scale (CDS). One hundred and fifty-one residents were included (mean age 73 years, 41% women). Fifty (33.1%) were identified as non-frail, 49 (32.5%) as pre-frail, and 52 (34.4%) as frail by SHARE-FI. The overall Cronbach's alpha coefficient was 0.81. Factor analysis identified two components accounting for 69% of the variance, with the first and most important component being handgrip strength. SHARE-FI groups were significantly correlated with CDS scores (p<0.05). The Turkish version of SHARE-FI had good reliability and validity in a nursing home setting.