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Objective:To explore the effect of individual rehabilitation intervention on the clinical outcome of patients with acute decompensated heart failure.Methods:A total of 152 elderly patients with acute decompensated heart failure in a tertiary hospital from January 2017 to December 2018 were selected and randomly assigned to the test group and the control group. The test group developed individualized interim rehabilitation interventions based on the evaluation results of balance, mobility, muscle strength and endurance of patients. The control group only performed routine rehabilitation related health care and discharge follow up, the short physical performance battery and the rate of all-cause readmission 6 months after discharge were compared between the two groups.Results:Finally, 144 patients finished the reseach, 72 patients in each group. After 3 months of intervention, the total scores of balance test, 4-meter timed walking, time to complete 5 chair rise and SPPB in the test group were 3.05±1.01, 3.74±0.58, 2.75±0.76, 9.44±2.16, while those in the control group were 2.82±0.86, 3.30±1.02, 2.24±0.74, 8.33±2.46. There was significant difference between the two groups ( t value was from -5.287 to -2.001, P<0.01) . Six months after discharge, the all-cause readmission rate was 12.5% (9/72) in the test group and 23.6% (17/72) in the control group, the difference was statistically significant ( t value was -0.348, P<0.05). Conclusions:The individual rehabilitation exercise based on the results of physical function evaluation can effectively improve the patients' body function and quality of life. Besides this, it can reduce the rate of all-cause readmission 6 months after discharge, which can provide reference for the transitional rehabilitation training of the elderly patients with acute decompensated heart failure.
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ABSTRACT BACKGROUND: Dyspnea and poorer physical performance are conditions that may be related and be present among the elderly. However, few studies have evaluated associations between these variables. OBJECTIVE: To determine whether there is an association between dyspnea and physical performance among community-dwelling older adults of both sexes (age 60 years and over). DESIGN AND SETTING: Cross-sectional study conducted in the city of Macapá, state of Amapá, Brazil. METHODS: Socioeconomic and health data were collected using a structured form. Frailty syndrome was assessed based on the frailty phenotype proposed by Fried et al. Dyspnea was measured using the modified Medical Research Council (mMRC) scale and physical performance was measured using the Short Physical Performance Battery (SPPB). Data were analyzed using a linear regression model. RESULTS: A total of 411 subjects (70.15 ± 7.25 years) were evaluated, most of them females (66.4%). It was observed from the mMRC scale that 30.9% (n = 127) of the subjects had some dyspnea symptoms: grade 1 was most frequent. The physical performance score from the SPPB was 9.22 ± 2.01. Higher dyspnea scores were associated with poor physical performance, both in the crude analysis (β = -0.233; P = 0.028) and after adjustment for frailty condition (β = -0.148; P = 0.002) and for the socioeconomic and health variables (age, sex, number of diseases, smoking habit and frailty status) (β = -0.111; P = 0.025). CONCLUSION: Higher dyspnea score was independently associated with poor physical performance among community-dwelling older adults.
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Humans , Male , Female , Aged , Frail Elderly , Independent Living , Brazil , Geriatric Assessment , Cross-Sectional Studies , Dyspnea , Physical Functional PerformanceABSTRACT
To evaluate several tests of physical performance for sarcopenia screening and assessment, by investigating physical performance and function in older women. 106 community-dwelling older women from a community in Shanghai were enrolled in this study. Physical function assessed by short physical performance battery (SPPB), timed get-up-and-go (TUG), handgrip strength, and usual gait speed were asked to perform. Total lean mass was determined by Dual energy X-ray absorptiometry, the relative appendicular skeletal muscle mass ( RASM) was defined as appendicular skeletal muscle mass/height2 . 13 individuals were diagnosed as sarcopenia according to a consensus diagnostic criteria for sarcopenia, as developed by the Asian Working Group for Sarcopenia ( AWGS) in 2014. Body mass index and handgrip strength in the sarcopenia group were significantly lower than those in the non-sarcopenia group (P=0. 026, P=0. 004 respectively), and there was no significant differences in the age, SPPB score, TUG, and usual gait speed. Linear regression analysis showed RASM was significantly positively correlated with body mass index (r=0. 842, P<0. 01), time to rise from a chair and return to the seated position five times (r=0. 203, P=0. 036),TUG(r=0. 258, P=0. 008)and grip strength (r=0. 217, P=0. 025), meanwhile, both body mass index and grip strength entered Logistic regression analysis. Low weight and low handgrip strength are independent predictive factors of sarcopenia in older women. Sarcopenia screening for older women with low body-weight and weak handgrip strength is more urgently required
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OBJECTIVE: To evaluate the association between baseline characteristics, three physical performance tests and fall history in a sample of the elderly from Korean population. METHODS: A total of 307 participants (mean age, 76.70±4.85 years) were categorized into one of two groups, i.e., fallers and non-fallers. Fifty-two participants who had reported falling unexpectedly at least once in the previous 12 months were assigned to the fallers group. Physical performance tests included Short Physical Performance Battery (SPPB), Berg Balance Scale (BBS), Timed Up and Go test. The differences between the two study groups were compared and we analyzed the correlations between fall histories and physical performance tests. RESULTS: SPPB demonstrated a significant association with fall history. Although the BBS total scores did not show statistical significance, two dynamic balance test items of BBS (B12 and B13) showed a significant association among fallers. CONCLUSION: This study suggests that SPPB and two dynamic balance test items of the BBS can be used in screening for risk of falls in an ambulatory elderly population.
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Aged , Humans , Accidental Falls , Cross-Sectional Studies , Mass ScreeningABSTRACT
JUSTIFICATIVA E OBJETIVOS: Com o envelhecimento entra-se em processo de declínio fisiológico, o que pode acarretar em incapacidade funcional e levar o idoso a ter quedas. Estudos demonstram que a prática de exercícios físicos pode interferir positivamente na sua prevenção. O objetivo deste estudo foi avaliar o desempenho físico em idosos que praticam atividade física regularmente e em sedentários, comparando-se os grupos. MÉTODO: Trata-se de estudo de corte transversal onde foram avaliados 30 idosos através da aplicação de questionário baseado na avaliação geriátrica ampla e no teste Short Physical Performance Battery (SPPB), que avalia por meio de escore de tempo o equilíbrio, a velocidade da marcha e a força de membros inferiores. RESULTADOS: No escore total do SPPB, observou-se que os idosos ativos apresentaram melhores resultados em relação aos sedentários, estando este grupo enquadrado em maior proporção na graduação máxima do teste, apresentando 'bom desempenho', (sedentários 40% - ativos 73%), a graduação de 'moderado desempenho' foi encontrada maior nos sedentários (sedentários 40% - ativos 26%), e a graduação de 'baixo desempenho' foi encontrada somente no grupo dos sedentários (26%). CONCLUSÃO: Obteve-se melhor desempenho na capacidade funcional entre os idosos ativos em relação aos sedentários. Concluiu-se, a partir destes dados, que a prática regular de exercícios físicos influencia positivamente na prevenção de quedas, funcionalidade e melhor qualidade de vida para o idoso.
BACKGROUND AND OBJECTIVES: With the aging process a physiological decline begins, which can lead to a functional inability and, consequently, lead the elderly to fall. Studies show that physical exercises may positively affect the prevention of falls in the elderly. This article aims to evaluate the physical performance between sedentary elderly people and those who practice regular physical activity, comparing these groups. METHOD: This is a cross-sectional study where 30 elder people were evaluated by applying a questionnaire based on a wide geriatric evaluation and the Short Physical Performance Battery test (SPPB) which evaluates through score time the balance, gait speed and strength of lower limbs. RESULTS: On the SPPB total score, it was noticed that the active subjects showed better results comparing to the sedentary ones, being among that group those with the maximum score, presenting "good performance" (sedentary 40% - actives 73%). The "moderate performance" was most found among sedentary ones (sedentary 40% - actives 26%), and the "low performance" was found only among sedentary elderly (26%). CONCLUSION: As results, we observe a better performance of functional capacity among active elder people comparing to the sedentary ones. We conclude from these data that the regular practice of physical exercise has a positive effect on prevention of falls, functionality and therefore in a better quality of live for the elderly.
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Humans , Male , Female , Aged , Aged, 80 and over , Accidental Falls , Aged , Motor Activity , Surveys and QuestionnairesABSTRACT
OBJECTIVE: To determine the relationship and difference of the Short Physical Performance Battery (SPPB) between normal population and stroke patients, and to examine the relationship of the SPPB that used to assess lower extremity function in old, and Functional Independence Measure (FIM), Modified Barthel Index (MBI) in stroke patients. METHOD: One hundred and fifty nine stroke patients and 159 sex, age-matched normal population were included. All subjects were enrolled to interview and administer the SPPB and FIM, MBI. The SPPB included assessment of standing balance, a walking speed (timed 4 m walk), and chair stand (timed test of rising 5 times from a chair). RESULTS: The stroke patients showed significantly lower SPPB score than control group. The age, sex, direction of affection, and duration of stroke did not influence SPPB score respectively. In comparison of FIM and MBI, SPPB was significantly correlated with FIM and MBI, especially motor subtotal score of FIM. CONCLUSION: SPPB may be useful tool to assess and predict the physical function in stroke patients.
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Humans , Lower Extremity , Stroke , WalkingABSTRACT
OBJECTIVE: To investigate a characteristics of short physical performance battery (SPPB) in some Korean rural community and to obtain a preliminary data of SPPB in Korea. METHOD: A total of 488 persons aged 22 to 82 with no disability, interviewed and administered a SPPB and a balance test using Mediance(R). Subjects were divided into 3 groups with high (less than 6 points), medium (7 to 9 points) and low (10 to 12 points) risk groups according to SPPB score. Lower extremity performance was measured using SPPB including assessment of standing balance, a timed 4-m walk, and timed test of rising 5 times from a chair. Chronic condition were ascertained as self-report of past disease history. The relationship between general characteristics of subjects, self-report of past history of disease, limb load asymmetry, postural sway and SPPB score were statistically analyzed. RESULTS: In a multivariate analysis, older age, lower educational background and high body fat mass were associated independently with poor performance. In a multivariateanalysis of subjects aged 60 or older, older age, lower educational background and history of hypertension were associated independently with poor performance. CONCLUSION: These findings should be considered in planning specially tailored intervention for disability prevention in this subgroups. And this study provides the preliminary evidence that a SPPB is a useful tool in evaluating Korean elderly who are not disabled but have poor lower extremity performance.