Prevalence and associated risk factors of sarcopenia in community-dwelling older adults in Pakistan: a cross-sectional study.

BACKGROUND: Advancements in medical facilities have led to an increase in global life expectancy, emphasizing the need to address age-related health issues. Sarcopenia, characterized by muscle mass loss, poses significant challenges for older adults. Despite a higher prevalence in Asian populations, there is a remarkable absence of studies addressing sarcopenia among the older adults in Pakistan. This research aims to determine sarcopenia prevalence, identify risk factors, and explore gender- and age-specific patterns among older adults in Pakistan. METHODS: A cross-sectional study involving 142 participants (65 males, 77 females) aged 60 and above was conducted using DEXA scans. Over a six-month period from January to June 2023, data were collected from the Islamabad Diagnostic Centre. This comprehensive dataset covered anthropometric measurements, body composition details, and health parameters. Statistical analyses, including logistic regression, were employed to examine the associations between sarcopenia and various factors. RESULTS: Sarcopenia manifested in 47.18% of the older adult population (n = 142), with a distribution of 39 males (60%) and 28 females (36.36%). The investigation unveiled a compelling correlation between underweight status and sarcopenia across genders. Indeed, males exhibited a significant negative correlation between skeletal muscle mass index and age, whereas females did not show a statistically significant association. Males presented higher odds of sarcopenia in comparison to females (Odds Ratio [OR] = 2.63, 95% Confidence Interval [CI]: 1.33-5.18, p = 0.005). Age (OR = 1.12, 95% CI: 1.02-1.22, p = 0.014), lower BMI (OR = 0.35, 95% CI: 0.20-0.60, p < 0.001), and reduced body fat percentage (OR = 1.75, 95% CI: 1.31-2.33, p < 0.001) emerged as significant contributors to sarcopenia. These detailed gender-specific findings emphasize the importance of customizing intervention strategies to address gender disparities in sarcopenia risk factors. CONCLUSION: This study highlights the significant prevalence of sarcopenia among older adults in Pakistan, with distinct gender and age-related patterns observed. The overall prevalence of sarcopenia was found to be 47.18%, with higher rates among males compared to females. Age emerged as a significant risk factor, with each additional year increasing the odds of sarcopenia. Furthermore, weight, BMI, lean mass, and total body fat demonstrated important associations with sarcopenia prevalence, highlighting the multifaceted nature of this condition. The practical implications of this study emphasize the need for targeted screening programs and personalized interventions to mitigate sarcopenia's impact, informing healthcare policies and public health strategies in Pakistan.

Effects of Virtual Reality Training Using Xbox Kinect on Balance, Postural Control, and Functional Independence in Subjects with Stroke.

Purpose: To determine the effects of virtual reality training using Xbox Kinect on balance, postural control, and functional independence in subjects with stroke. Methods: The parallel double-blind randomized control trial was conducted on 41 individuals based on selection criteria. Participants were divided into two groups by concealed envelope method. Intervention group received exergaming by Xbox Kinect, and control group was given exercises comprising balance training, upper limb strengthening, and core strengthening. Berg balance scale (BBS), functional independence measure (FIM), trunk impairment scale (TIS), and timed up and go (TUG) were the outcome measures. Data were analyzed using SPSS v21. Results: Mean age of the participants of Xbox and exercise group were 58.6 ± 3.3 and 58.1 ± 4.3 years, respectively. Within group improvement was observed in both groups from baseline to 8 weeks postintervention; BBS: 34 ± 4.7 to 40.9 ± 4.9 in intervention group and 34.1 ± 4.4 to 38.1 ± 7.6 in control group, TUG: 25.6 ± 3.9 to 21.4 ± 3.8 and 28.6 ± 5.0 to 25.9 ± 4.7, TIS: 15.2 ± 1.8 to 19.2 ± 1.3 and 13.2 ± 1.7 to 15.3 ± 1.6 and FIM: 58.7 ± 7.7 to 52.5 ± 7.8 and 66.2 ± 7.6 to 62.6 ± 7.2 in intervention and control group, respectively. Between group improvement was observed in TUG, TIS, and FIM in experimental group with P-values 0.003, <0.001, and <0.001, respectively. Conclusions: Wii Fit improved functional mobility, independence, and trunk coordination extension in the stroke patients, whereas balance could be equally improved from Wii Fit and exercises. Trial Registration Number: ACTRN12619001688178.

Factors associated with joint contractures in adults: a systematic review with narrative synthesis.

PURPOSE: The primary objective of the review was to collate the available evidence on factors associated with joint contractures in adults. METHODS: A systematic literature search was conducted on MEDLINE, CINAHL, AMED, and EMBASE. Studies that involved participants aged ≥18 and assessed joint contracture as a primary or secondary outcome were included. Two independent reviewers screened studies against the eligibility criteria, performed data extraction, and assessed the quality of evidence. A narrative synthesis by domain and sub-domain was undertaken. The protocol was registered on PROSPERO: CRD42019145079. RESULTS: Forty-seven studies were included in the review. Identified factors were broadly classified into three major domains: sociodemographic factors, physical factors, and proxies for bed confinement. Sociodemographic factors were not associated with joint contractures. Functional ability, pain, muscle weakness, physical mobility, and bed confinement provided the most consistent evidence of association with joint contractures. The evidence regarding the relationship between spasticity and joint contractures remains unclear. Other factors might be important, but there was insufficient evidence to make inferences. CONCLUSIONS: The review identified and collated evidence on factors associated with joint contractures, which can be utilised to develop effective prevention and management strategies. Implications for rehabilitationClinical interventions based on the timely identification of risks related to joint contractures in vulnerable adults have the potential to prevent or ameliorate their development or progression.Quality and consistency of care for vulnerable adults would be enhanced by developing effective joint contracture prevention and rehabilitation strategies based on the evidence presented in this review.As many vulnerable adults are located in the community or non-acute care settings, strategies should target these loci of care.Structured risk assessments that can support non-physiotherapy staff working in these loci of care to identify risks related to joint contractures would provide an important resource for risk management.

Prevalence of musculoskeletal disorders among chefs working in restaurants of twins cities of Pakistan.

BACKGROUND: In the recent era, musculoskeletal disorders have affected millions of people worldwide. Chefs and other workers of the catering industry are at high risk of physical stresses, which makes them susceptible to develop various musculoskeletal pains and disorders. OBJECTIVE: The aim of the study is to examine the frequency of musculoskeletal symptoms among chefs working in restaurants of Islamabad and Rawalpindi. METHODS: A cross-sectional observational study was conducted on 307 chef participants from the restaurants of the twin cities. The participants were included via convenient sampling and data was collected through Nordic Musculoskeletal Questionnaire (NMQ), Fatigue Assessment Scale (FAS) and Numeric Pain Rating Scale (NPRS) from February to July 2021. RESULTS: Out of 307 participants, 285 were males and 22 were females with a mean age of 32.87±7.03 years. The working duration of 192 chefs were 9-12 hours while 106 and 9 chefs worked only for 4-8 and more than 12 hours, respectively. A total of 101 chefs reported lower back and knee pain. The chefs presented with pain in the shoulders, upper back and ankle as well as feet areas were 98, 93 and 26 respectively. CONCLUSION: Chefs can develop musculoskeletal symptoms including pain as a result of increased physical stress on their bodies during their work, specifically in the lower back and knee area.

Association of sleep-wake pattern with cognitive performance and academic achievement in young adults.

OBJECTIVE: To determine the association of sleep wake pattern with cognitive performance and academic achievement in young adults. Method: It was a cross sectional study conducted in March 2019 after approval from the Institutional Review Board & Ethics Committee of the study setting on February 28, 2019. Total sample of the study was 189 calculated by using Rao software. Inclusion criteria was healthy young adults of age 18 to 24 years from Doctor of Physical Therapy department of Shifa Tameer-e-Millat University, Dar-ul-Shifa campus, Islamabad. Exclusion criteria included all those students who were married, diagnosed with psychological disorder and were taking any sedatives. Data was collected through three questionnaires named Pittsburgh Sleep Quality Index (PSQI), Morningness-Eveningness Questionnaire (MEQ) and Montreal Cognitive Assessment (MOCA) in addition to inquiry regarding GPA of latest exam. RESULTS: A total sample was 236 students with a mean age of 20.94±1.58 years with range 18-24 years. The sample comprised of males n=24 (10.2%) and females n=212(89.8%). Mean GPA was 3.10±0.53. MOCA showed that 70(29.66%) students had mild cognitive impairment, 166(70.34%) were students with normal cognition. The results obtained by applying independent T-test showed a significant difference of cognition between high and low achievers (p-value: 0.029<0.05. Students who scored high were definite morning types. CONCLUSIONS: There is a significant association between cognitive performance and academic achievement with high achievers being definite morning types.

Role of Physical Therapy in Palliative Care of Cancer Patients.

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Role Wii Fit exer-games in improving balance confidence and quality of life in elderly population.

OBJECTIVE: To determine the effects of Wii Fit exer-gaming on balance confidence, quality of life and fall risk in elderly population. METHODS: The double-blind randomised control trial was conducted at Kulsum International Hospital, Islamabad, Pakistan, from July 31 to October 30, 2018, and comprised vitally stable, physically independent subjects of either gender aged 60 years and above, having no serious systemic disease. The subjects were randomly allocated into experimental group A and control group B using the concealed envelope method. After baseline assessment, group A received Wii fit gaming, while group B received balance training for 30 minutes twice a week for 8 weeks. Activities balance confidence (ABC), European Quality of Life-5 Dimensions (EQ 5D-5L), timed up and go (TUG) and Fukuda were used to assess the impact of the intervention. Data was analysed using SPSS 21. RESULTS: Of the 90 subjects, 83(92.2%) completed the study. There were 51(62%) males and 32 (38%) females; and 45(50%) in each of the two groups. Group A had 42(50.6%) subjects with 26(62%) males and 16(38%) females, and 41 were in group B, with 25(61%) males and 16(39%) females. Balance confidence improved in both groups, but it was significantly higher in group A (p<0.001). Mobility, self-care, usual activities, pain/discomfort, anxiety/depression as well as timed up and go and Fukuda showed significantly more improvement in group A compared to group B (p<0.05). CONCLUSIONS: Wii fit was found to have the potential to improve balance confidence and quality of life, reducing the fall risk among the elderly. CLINICAL TRIAL NUMBER: IRCT20180417039344N1 by Iranian Registry of Clinical Trials.

Effects of Wii Fit exer-gaming on balance and gait in elderly population: A randomized control trial.

OBJECTIVE: To assess the effect of exer-gaming on balance and gait in the elderly. Methods: The randomised controlled trial was conducted at Kulsum International Hospital, Islamabad, Pakistan, from July to October 2018, and comprised physically independent subjects aged 60 years and above who were randomised into experimental and control groups using concealed envelope method. The cases received exer-gaming for 30 minutes twice a week for 8 weeks, while the controls received balance training exercises twice a week for 8 weeks. Assessment was done at baseline and after 8 weeks of intervention. Outcome measures were assessed with Berg balance scale and the gait abnormality rating scale modified. Data was analysed using SPSS 21. RESULTS: Of the 90 subjects, there were 45(50%) in each of the two groups. The intervention group had better outcome in terms of gait (p<0.05) except for foot contact and shoulder extension (p>0.05), while the difference related to balance was not significant (p>0.05). CONCLUSIONS: Exer-gaming was found to be effective in improving various components of gait in the elderly compared to exercises.