Journal of Geriatric Physical Therapy最新文献

{"title":"A Scoping Review of Interventions Aimed at Reducing Fear of Falling in Older Adults With Orthopedic Conditions.","authors":"Sahar Johari, Joy MacDermid, Pulak Parikh, Ruby Grewal","doi":"10.1519/JPT.0000000000000426","DOIUrl":"https://doi.org/10.1519/JPT.0000000000000426","url":null,"abstract":"<p><strong>Background and purpose: </strong>Fear of falling (FoF) is a persistent anxiety regarding the risk of falling, which can even impact individuals without a history of falls. Fear of falling has been associated with decreased physical functioning and increased risk of falls. Most interventions have focused on reducing FoF in healthy older adults. This study aimed to review the literature's scope, nature, and content related to FoF interventions in older adults with orthopedic conditions.</p><p><strong>Methods: </strong>A scoping literature review was conducted. The method steps included identifying the research question, identifying relevant studies, selecting the studies, charting the data, and synthesizing, summarizing, and reporting the results. Cochrane Library, Medline, PsycINFO, Embase, ProQuest, and Google Scholar were searched. The search strategy used a set of key concepts, including \"Fear of Falling,\" \"Orthopedic conditions,\" \"Interventions,\" and \"Older adults.\"</p><p><strong>Results and discussion: </strong>Out of the 33 articles that fulfilled the inclusion criteria, 21 were randomized control trials (RCTs), 5 were RCT protocols, 3 were quasi-experimental studies, 2 employed pre-post designs, 1 was a prospective cohort study, and 1 was an experimental study. The review revealed 7 distinct categories of interventions: exercise training, cognitive behavioral therapy, enhanced occupational or physical therapy (OT or PT), motivational interviews, interdisciplinary interventions, education, and mind-body intervention. The Falls Efficacy Scale (FES) was the most frequently used outcome measure for assessing FoF. Other measures were the Fear of Falling Questionnaire (FoFQ), the International Physical Activity Questionnaire (IPAQ), and the Perceived Ability to Manage Fall (PAMF). The studies varied in their reasoning, content, and how they reported findings, posing challenges for healthcare professionals in choosing and applying FoF intervention programs specific to various orthopedic conditions.</p><p><strong>Conclusion: </strong>This review highlighted the need for adopting more comprehensive approaches for assessing and addressing FoF in older adults with orthopedic conditions.</p>","PeriodicalId":49035,"journal":{"name":"Journal of Geriatric Physical Therapy","volume":"48 1","pages":"42-51"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research Among People Living With Dementia or Mild Cognitive Impairment in Physiotherapy Journals: A Scoping Review.","authors":"Humberto Omaña, Winifred Twum-Ampofo, Susan W Hunter","doi":"10.1519/JPT.0000000000000437","DOIUrl":"https://doi.org/10.1519/JPT.0000000000000437","url":null,"abstract":"<p><strong>Background and purpose: </strong>Global estimates forecast an increase in the number of people living with dementia (PLWD) or mild cognitive impairment (MCI). Physiotherapists play an important role in the delivery of care to PLWD or MCI; however, physiotherapists report less confidence when working with PLWD or MCI, citing limited educational opportunities. Our scoping review sought to quantify and assess the type of research published in physiotherapy journals related to these groups of people.</p><p><strong>Methods: </strong>Fifteen journals were selected based on global physiotherapy representation, indexing, and online accessibility of archives. Extraction of all articles published within a decade (2011-2021) for the selected journals was completed. Inclusion criteria: (1) research reports, reviews, case studies, or expert opinion pieces related to PLWD or MCI and (2) published in English. Each article was categorized by type of article, clinical setting, type of dementia, physiotherapy focus, and Sackett's system of hierarchy of evidence. An analysis of trends over time and a bibliometric assessment of research impact were performed.</p><p><strong>Results and discussion: </strong>Of 11 091 articles identified, 67 were included. The most common country of origin was the United States (38.8%). Articles were mainly research reports (70.1%), from a community-dwelling setting (50.8%), with a combined physiotherapy focus (28.4%), and a level IV (37.3%) of hierarchy of evidence. Close to half of studies did not identify the underlying dementia type (43.3%, n = 29), followed by people living with Alzheimer's dementia (28.4%, n = 19), combined groups of PLWD or MCI (20.9%, n = 14), and individuals with only MCI (7.5%, n = 5). Six articles on average related to PLWD or MCI were published annually (32.7 citation per article), and no growing trend was observed.</p><p><strong>Conclusions: </strong>Few articles published in prominent physiotherapy journals over the last decade were related to PLWD or MCI. Publication trends remained unchanged, and publication origins were from the Americas which impacts generalizability. Physiotherapists should attain complementary information on care for PLWD or MCI through more general rehabilitation journals. Physiotherapy journals should seek to promote research related to PLWD or MCI through different avenues (eg, special issues) as increased information is needed for clinicians to feel confident in providing informed care.</p>","PeriodicalId":49035,"journal":{"name":"Journal of Geriatric Physical Therapy","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142898920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survey of Geriatric Competencies and Curricular Models in Entry-Level DPT Programs in the United States.","authors":"Justin T Mierzwicki, Karen M Blood","doi":"10.1519/JPT.0000000000000432","DOIUrl":"https://doi.org/10.1519/JPT.0000000000000432","url":null,"abstract":"<p><strong>Background and purpose: </strong>Nearly 2 decades have elapsed since the last national survey examining entry-level PT geriatric content. Furthermore, no survey has been completed investigating the extent to which the \"Essential Competencies in the Care of Older Adults at the Completion of Entry-level Physical Therapist Professional Program of Study\" were incorporated into DPT programs. The purpose of this study is to identify the extent to which DPT programs include geriatric topics and the Essential Competencies within curricula and determine geriatric content requiring proficiency for entry-level practice.</p><p><strong>Methods: </strong>A survey was developed in Qualtrics™ and distributed via email 4 times over 2 months in 2023 to DPT program chairs and APTA social media platforms. The survey contained sections on geriatric curriculum models, environment of content coverage, incorporation of Essential Competencies, and skills requiring entry-level proficiency. Data analysis was completed using descriptive statistics.</p><p><strong>Results and discussion: </strong>Responses were received from 134/276 programs. Seventy-nine and nine tenths percent of responding programs have a dedicated geriatric course, 93.4% of which require 1 geriatric course, with a mean of 2.6 credits (SD 1.02). In programs without dedicated geriatric courses, a mean of 2.7 credit hours (SD 2.88) of geriatric content was reported. Eighty-nine percent of programs cover age-related changes to major body systems and balance and fall screening, with <60% addressing interventions for cognition and social isolation. Of the surveyed Essential Competencies, 80.4% were incorporated into >70% of programs. A total of 31.6% of the tests and measures were taught, 15.8% were practiced, and 10.5% were identified by >70% of programs as requiring proficiency for entry-level practice.</p><p><strong>Conclusions: </strong>There is variation in geriatric content incorporated into entry-level DPT programs and moderately robust uptake of Essential Competencies. Entry-level education may not meet APTA-Geriatrics Best Practice guidelines with relatively few tests, measures, and interventions recommended with consensus to be proficient prior to entry-level practice. Improved knowledge translation and curricular guidance may help reduce practice variation and enhance entry-level education in geriatric physical therapy.</p>","PeriodicalId":49035,"journal":{"name":"Journal of Geriatric Physical Therapy","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of the Revised Entry-Level Essential Competencies in the Care of Older Adults: Linking Domains of Competence, Commission on Accreditation in Physical Therapy Education Standards, and the Geriatric 5Ms.","authors":"Karen M Blood, Justin T Mierzwicki, Barbara Billek-Sawhney, Jill Heitzman, Lisa R Dehner, Nicole Dawson, Gregory W Hartley","doi":"10.1519/JPT.0000000000000436","DOIUrl":"https://doi.org/10.1519/JPT.0000000000000436","url":null,"abstract":"<p><strong>Purpose: </strong>Geriatric physical therapy (PT) has evolved since 2011, when the Essential Competencies (ECs) in the Care of Older Adults at the Completion of the Entry-level Physical Therapy Professional Program of Study were published. The purpose of the ECs was to ensure that all entry-level physical therapists were prepared to meet the unique needs of the growing older adult population. Changes in population demographics, medical and research advances, coupled with advancements in the profession of PT, necessitate a revision of the ECs.</p><p><strong>Process: </strong>The Academic Education Committee of APTA Geriatrics was convened to revise the original ECs. Participation was solicited and obtained from experts in clinical and academic geriatric PT; committee work lasted from 2021 to 2024. The committee recognized the intersection of the Domains of Competence Framework developed by the American Physical Therapy Association (APTA), American Council of Academic Physical Therapy, and the Academy of Education partnership, the geriatric medicine 5Ms model, and the Commission on Accreditation in Physical Therapy Education (CAPTE) standards in guiding entry-level PT education. The committee determined that the Domains of Competence, Geriatric 5Ms, and CAPTE standards could synergistically enhance the establishment of contemporary ECs. Input from a nonresearch-based informational survey of APTA Geriatrics members, supported by feedback from discussion at a platform presentation at the APTA's Combined Section Meeting San Diego 2023, informed the revised ECs presented in the current manuscript.</p><p><strong>Outcome: </strong>This manuscript presents the revised ECs and describes how each EC links to the Domains of Competence, the Geriatric 5Ms, and CAPTE standards. The updated ECs aim to promote best practices in entry-level PT education by providing all stakeholders clear and concise competency statements for the physical therapy examination and treatment of older adults.</p>","PeriodicalId":49035,"journal":{"name":"Journal of Geriatric Physical Therapy","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between SARC-F and Clinical Outcomes in Older Adults With Cardiovascular Diseases Admitted to the Emergency Room: A Longitudinal Study.","authors":"Luciana D L Sousa, Paloma B de Lima, Mariana D G Dos Santos, Osmair G de Macedo, Tiago D S Alexandre, Patrícia A Garcia","doi":"10.1519/JPT.0000000000000438","DOIUrl":"https://doi.org/10.1519/JPT.0000000000000438","url":null,"abstract":"<p><strong>Introduction: </strong>Sarcopenia can be more significant and severe in the presence of cardiovascular diseases. In hospitalized older adults with acute cardiac disease, assessing strength parameters, muscle mass, and physical performance is difficult largely because of bed rest restrictions. In this context, simple questionnaire to rapidly diagnose sarcopenia (SARC-F) emerges as a feasible screening tool to identify sarcopenia in an emergency room setting.</p><p><strong>Objectives: </strong>Assess the association between SARC-F, length of stay, mechanical ventilation, and in-hospital mortality in older adults with cardiovascular diseases admitted to the ER.</p><p><strong>Methodology: </strong>An observational longitudinal study with 160 Brazilian older adults with cardiovascular diseases admitted to the hospital following an ER visit. The risk of sarcopenia was assessed by the SARC-F tool (independent variable). Length of stay, use of mechanical ventilation, and in-hospital mortality were the dependent variables, collected via an electronic medical chart. Data were analyzed by simple and multiple linear and logistic regression.</p><p><strong>Results: </strong>SARC-F explained 62% of length of stay, adjusted for the confounding variables age, male sex, and use of continuous medication, mechanical ventilation, and corticosteroids. Risk of sarcopenia was also associated with mechanical ventilation during hospitalization (odds ratio = 1.398; 95% CI, 1.018-1.919). SARC-F was not related to mortality.</p><p><strong>Conclusion: </strong>Older adults with cardiovascular diseases hospitalized at greater risk of sarcopenia were more likely to need invasive mechanical ventilation and more prone to prolonged hospital stays.</p>","PeriodicalId":49035,"journal":{"name":"Journal of Geriatric Physical Therapy","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Importance of Racially and Ethnically Inclusive Gait Speed Reference Values in Individuals 90 Years and Older: LifeAfter90.","authors":"Katherine A Colcord, Paola Gilsanz, Kristen M George, Claudia H Kawas, Luohua Jiang, Rachel A Whitmer, María M Corrada","doi":"10.1519/JPT.0000000000000416","DOIUrl":"10.1519/JPT.0000000000000416","url":null,"abstract":"<p><strong>Background and purpose: </strong>Clinicians use reference values to contextualize physical performance scores, but data are sparse in individuals 90 years and older and racial/ethnic diversity is limited in existing studies. Gait speed provides valuable information about an individual's health status. Slow gait speed is associated with falls, cognitive decline, and mortality. Here, we report gait speed reference values in a racially/ethnically diverse oldest-old cohort.</p><p><strong>Methods: </strong>LifeAfter90 is a multiethnic cohort study of individuals 90 years and older. Participants are long-term members of an integrated healthcare delivery system without a dementia diagnosis at enrollment. We assessed gait speed using the 4-m walk test and calculated means, standard deviations, and percentiles by age, sex, assistive device use, and device type. We used linear regression to compare means by sex, age, device use and type, living situation and arrangement, and race/ethnicity.</p><p><strong>Results and discussion: </strong>The mean age of the 502 participants was 92.9 (range 90.1-102.8) years. Of these, 62.6% were women, 34.7% were college educated, 90.8% lived in a private residence, 20.9% self-reported as Asian, 22.5% as Black, 11.8% as Hispanic, 35.7% as White, and 9.2% as multiple, \"other,\" or declined to state. The overall mean gait speed was 0.54 m/s (women = 0.51 m/s, men = 0.58 m/s). Mean gait speeds were 0.58 m/s, 0.53 m/s, and 0.48 m/s in the 90 to 91, 92 to 93, and 94+ age categories, respectively. In those without a device, mean gait speed was 0.63 m/s compared to 0.40 m/s in those with a device (cane = 0.44 m/s, walker = 0.37 m/s). Mean gait speed was significantly slower in women compared to men, age category 94+ compared to 90 to 91, participants with a device compared to those without, participants with a walker compared to a cane, and Black participants compared to Asian and White participants. However, differences by race/ethnicity were attenuated when chronic health conditions were considered.</p><p><strong>Conclusions: </strong>Reference values developed from this multiethnic 90+ cohort will help clinicians interpret gait speed measures and tailor recommendations toward a 90+ population that is growing in number and in racial/ethnic diversity.</p>","PeriodicalId":49035,"journal":{"name":"Journal of Geriatric Physical Therapy","volume":" ","pages":"202-213"},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Step Test Evaluation of Performance on Stairs (STEPS): Assessing Stair Function in Older Adults.","authors":"Deb Kegelmeyer, Raquel Minarsch, Katherine Marita, Audrey Hoffmeister, Gabrielle Schnaterbeck, Timothy Wohl, Yevgeniya Gokun, Anne Kloos","doi":"10.1519/JPT.0000000000000415","DOIUrl":"10.1519/JPT.0000000000000415","url":null,"abstract":"<p><strong>Background and purpose: </strong>Stair negotiation is crucial for functional independence and is a leading cause of fall-related injuries in older adults. The Step Test Evaluation of Performance on Stairs (STEPS) is a quick and easily administered outcome measure for assessing stair negotiation. This study investigated the reliability and concurrent content validity of the STEPS test to determine its usefulness in older adults.</p><p><strong>Methods: </strong>Eighty-two community-dwelling older adults (mean age 81.2 years, 51 females) were assessed on the STEPS test, Timed Up and Go (TUG), 5-times sit to stand (5XSTS), stair self-efficacy (SSE) questionnaire, and time to ascend and descend stairs. Participants repeated the STEPS test 7 to 14 days later for intrarater reliability by the same rater. Spearman rank and intraclass correlations were used to determine the association of measures and intrarater reliability.</p><p><strong>Results and discussion: </strong>The mean STEPS score was 15.6 (SD = 3.7) out of 20. The STEPS total score demonstrated excellent intra- and interrater reliability. It had moderate to good and significant correlations with TUG, 5XSTS, SSE, and time to ascend and descend measures. Faster performance on the 5XSTS, TUG, and time to ascend and descend correlated with better performance on the STEPS test, indicating validity for assessing balance and mobility during stair negotiation in older adults. Lower SSE correlated with lower observer ratings of performance on stairs (STEPS scores), indicating agreement between participant reports of self-efficacy and observer ratings of performance. Step Test Evaluation of Performance on Stairs items that demonstrated the most frequent loss of points were balance (use of handrail), step continuity, foot placement, and self-propulsion (ascent only).</p><p><strong>Conclusions: </strong>Assessment of older adults' safety and performance on stairs is vital given the increased difficulty of stair navigation and the high risk for injurious falls in this population. This study demonstrates that the STEPS test is a reliable and valid outcome measure for assessing stair performance in older adults.</p>","PeriodicalId":49035,"journal":{"name":"Journal of Geriatric Physical Therapy","volume":" ","pages":"214-221"},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140923338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intrarater and Interrater Reliability of Quantitative Ultrasound Speed of Sound by Trained Raters at the Distal Radius in Postmenopausal Women.","authors":"Cynthia J Watson, Matthew J de Ruig, Kent T Saunders","doi":"10.1519/JPT.0000000000000417","DOIUrl":"10.1519/JPT.0000000000000417","url":null,"abstract":"<p><strong>Background and purpose: </strong>Quantitative ultrasound (QUS) performed at the distal radius shows potential as an effective tool for evaluating fracture risk, especially in postmenopausal women, but the reliability of this tool has not been reported in this patient population. This study investigated the within-day intrarater and interrater reliability of trained raters performing QUS measures at the distal radius of postmenopausal community-dwelling women.</p><p><strong>Methods: </strong>Eighteen women between the ages of 56 and 87 years were recruited from senior centers in the Greenville area of South Carolina and consented to participate. A QUS bone sonometer was used in this study; the trained raters performed 3 repeated speed of sound (SOS) measures at the nondominant radius of each participant on the same day. Intraclass correlation coefficients (ICCs) were calculated (model 3,1 for intrarater and 2,3 for interrater reliability) to determine the reliability within and between raters. In addition, we calculated the standard error of measurement (SEM) and the minimal detectable change at 95% confidence interval (MDC 95 ).</p><p><strong>Results: </strong>The within-day intrarater reliability was excellent for both physical therapist raters (ICC (3,1) ranging from 0.93 to 0.91). The SEM and MDC for the within-day intrarater reliability measures were small for both raters (SEM = 36.79-38.75 or 0.92%-0.97% of the pooled mean; MDC 95  = 101.99-107.40). The interrater reliability for SOS measurements using radial QUS was good with an ICC (2,3) of 0.77 (95% CI, 0.36-0.92) for 3 averaged measures. The SEM and MDC were larger for the interrater reliability measures (SEM = 62.79 or 1.57% of the pooled mean; MDC 95  = 174.05).</p><p><strong>Conclusions: </strong>Quantitative ultrasound SOS measurement at the distal radius showed excellent within-day intrarater and good interrater (when 3 measures were averaged) reliability in community-dwelling postmenopausal women. The SEM and MDC 95 were also low for interrater reliability when a mean of 3 trials was used. This study is the first to demonstrate that this particular QUS device at the radius may be a reliable fracture risk screening tool for postmenopausal women.</p>","PeriodicalId":49035,"journal":{"name":"Journal of Geriatric Physical Therapy","volume":" ","pages":"E159-E166"},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141856919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of Usual and Fast Gait Speed With Physical Performance and Balance Confidence in Community-Dwelling Older Adults: Implications for Assessment.","authors":"Chad Tiernan, David J Schwarz, Allon Goldberg","doi":"10.1519/JPT.0000000000000397","DOIUrl":"10.1519/JPT.0000000000000397","url":null,"abstract":"<p><strong>Background and purpose: </strong>Gait speed is a robust measure that offers many advantages clinically. However, decisions concerning its utilization exist, including whether to assess usual or fast gait speed. The current study aimed to identify whether usual or fast gait speed was more strongly associated with physical performance measures and balance confidence. A secondary aim was to explore these relationships within subgroups based on fall risk status.</p><p><strong>Methods: </strong>This was an observational study with a cross-sectional design involving 57 community-dwelling older adults (77.2% female; mean age = 68.8, SD = 6.5 years, range = 60-87 years) who were assessed on the following variables: usual and fast gait speed, knee extension strength, step execution time, 6-minute walk test (6MWT), and Activities-specific Balance Confidence Scale (ABC-6). Spearman ρ correlations were computed to determine bivariate associations of usual and fast gait speed with physical performance measures and balance confidence for the whole sample and within subgroups based on fall risk [lower fall risk (n = 28) vs higher fall risk (n = 29)]. Multiple linear regression models were estimated with either usual or fast gait speed as key predictors of knee extension strength, step execution time, 6MWT, and ABC-6.</p><p><strong>Results and discussion: </strong>Stronger correlations were observed for fast gait speed compared with usual gait speed with all physical performance measures and balance confidence for the entire sample and within the higher fall risk group. Multiple regression results indicated that models with fast rather than usual gait speed as the key predictor explained more of the variance in 6MWT ( R2 = 64.5% vs 45.6%), ABC-6 ( R2 = 28.5% vs 25.4%), step execution time ( R2 = 24.9% vs 19.0%), and knee extension strength ( R2 = 15.7% vs 7.2%).</p><p><strong>Conclusions: </strong>Fast gait speed showed stronger associations and better predictive capabilities compared with usual gait speed with physical performance measures and balance confidence in older adults. Despite being measured less often than usual gait speed, fast gait speed assessment warrants additional consideration.</p>","PeriodicalId":49035,"journal":{"name":"Journal of Geriatric Physical Therapy","volume":" ","pages":"192-201"},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41217199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Appendicular Skeletal Muscle Mass in Older Adults Can Be Estimated With a Simple Equation Using a Few Zero-Cost Variables.","authors":"Enrico Buccheri, Daniele Dell'Aquila, Marco Russo, Rita Chiaramonte, Michele Vecchio","doi":"10.1519/JPT.0000000000000420","DOIUrl":"10.1519/JPT.0000000000000420","url":null,"abstract":"<p><strong>Background and purpose: </strong>Assessing appendicular skeletal muscle (ASM) mass is crucial for the diagnosis of numerous pathologies related to the decline of muscle mass in old age, such as sarcopenia, malnutrition, or cachexia. The dual-energy X-ray absorptiometer (DEXA) radiological technique, which is the gold standard for its assessment, is particularly costly and not routinely used in clinical practice. The aim of this study was to derive computationally simple equations capable of estimating the DEXA-measured ASM at zero cost in older adult populations.</p><p><strong>Methods: </strong>We used the cross-sectional data collected by the National Health and Nutrition Examination Survey (NHANES) over 7 years (1999-2006). The study sample included 16,477 individuals aged 18 years and over, of which 4401 were over 60 years old. We considered 38 nonlaboratory variables. For the derivation of the equations, we employed the Brain Project, an innovative artificial intelligence tool that combines genetic programming and neural networks. The approach searches simultaneously for the mathematical expression and the variables to use in the equation. The derived equations are useful to estimate the DEXA-measured ASM.</p><p><strong>Results and discussion: </strong>A simple equation that includes the body weight of the patient as the sole variable can estimate the outcome of DEXA with an accuracy equivalent to previously published equations. When used to identify individuals over 60 years old with muscle mass loss, it achieved an area under the curve (AUC) value of 0.85 for both males and females. The inclusion of sex and anthropometric data (thigh and arm circumference) improved the accuracy for male individuals (AUC 0.89). The model is also suitable to be applied to the general adult population of 18 years of age or older. Using more than 3 variables does not lead to better accuracy.</p><p><strong>Conclusions: </strong>The newly proposed equations have better diagnostic accuracy than previous equations for the estimation of DEXA-measured ASM. They are readily applicable in clinical practice for the screening of muscle mass loss in the over 60-year-old population with nearly zero-cost variables. The most complex model proposed in this study requires only the inspection of a simple diagnostic chart to estimate the status of muscle mass loss.</p>","PeriodicalId":49035,"journal":{"name":"Journal of Geriatric Physical Therapy","volume":" ","pages":"E149-E158"},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141856918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}