A systematic review of the psychometric properties of physical performance tests for sarcopenia in community-dwelling older adults.

BACKGROUND: This review provides an overview of the psychometric properties of the short physical performance battery (SPPB), timed up and go test (TUG), 4 m gait speed test (4 m GST) and the 400 m walk test (400 m WT) in community-dwelling older adults. METHODS: A systematic search was conducted in MEDLINE, CINAHL and EMBASE, resulting in the inclusion of 50 studies with data from in total 19,266 participants (mean age 63.2-84.3). Data were extracted and properties were given a sufficient or insufficient overall rating following the COSMIN guideline for systematic reviews of patient-reported outcome measures. Quality of evidence (QoE) was rated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. RESULTS: The SPPB was evaluated in 12 studies, TUG in 30, 4 m GST in 12 and 400 m WT in 2. Reliability of the SPPB, TUG and 4 m GST was rated sufficient (moderate to good QoE). The measurement error of the SPPB was rated insufficient (low QoE). Criterion validity for the SPPB was insufficient in indicating sarcopenia (moderate QoE), while the TUG was sufficient and insufficient for determining mobility limitations (low QoE) and activities of daily living disability (low QoE), respectively. Construct validity of the SPPB, TUG, 4 m GST and 400 m WT was rated insufficient in many constructs (moderate to high QoE). Responsiveness was rated as insufficient for SPPB (high QoE) and TUG (very low QoE), while 4 m GST was rated as sufficient (high QoE). CONCLUSION: Overall, the psychometric quality of commonly used physical performance tests in community-dwelling older adults was generally rated insufficient, except for reliability. These tests are widely used in daily practice and recommended in guidelines; however, users should be cautious when drawing conclusions such as sarcopenia severity and change in physical performance due to limited psychometric quality of the recommended measurement instruments. There is a need for a disease-specific physical performance test for people with sarcopenia.This research received no specific grant from any funding agency and was registered a priori using the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42022359725).

Adherence to and Efficacy of the Nutritional Intervention in Multimodal Prehabilitation in Colorectal and Esophageal Cancer Patients.

Multimodal prehabilitation programs to improve physical fitness before surgery often include nutritional interventions. This study evaluates the efficacy of and adherence to a nutritional intervention among colorectal and esophageal cancer patients undergoing the multimodal Fit4Surgery prehabilitation program. The intervention aims to achieve an intake of ≥1.5 g of protein/kg body weight (BW) per day through dietary advice and daily nutritional supplementation (30 g whey protein). This study shows 56.3% of patients met this goal after prehabilitation. Mean daily protein intake significantly increased from 1.20 ± 0.39 g/kg BW at baseline to 1.61 ± 0.41 g/kg BW after prehabilitation (p < 0.001), with the main increase during the evening snack. BW, BMI, 5-CST, and protein intake at baseline were associated with adherence to the nutritional intervention. These outcomes suggest that dietary counseling and protein supplementation can significantly improve protein intake in different patient groups undergoing a multimodal prehabilitation program.

Resting energy expenditure measured by indirect calorimetry in mechanically ventilated patients during ICU stay and post-ICU hospitalization: A prospective observational study.

PURPOSE: The metabolic course during and after critical illness is unclear. We performed repeated indirect calorimetry (IC) measurements during ICU- and post-ICU hospitalization to determine resting energy expenditure (REE). METHODS: Prospective observational design. In ventilated ICU patients, IC measurements were performed every three days until hospital discharge. Measured REE as predicted by the Harris-Benedict equation (HBE-REE) and 25 kcal/adjusted body weight/day (25-REE) were compared. RESULTS: In 56 patients (38% females, 71[13]years, BMI 29(27;31)kg/m2), 189 ICU IC measurements were performed. Measured REE did not differ from HBE-REE at ICU admission, but was lower than 25-REE. Measured REE was increased compared to baseline on ICU-admission-day four (29(29-30)kcal/kg/day; mean difference 3.1(1.4-4.9)kcal/kg/day, p < 0.001) and thereafter during ICU admission. During post-ICU ward stay, 44 measurements were performed in 23 patients, showing a higher mean REE than during ICU stay (33(31-35)kcal/kg/day; mean difference 2.6(1.2-3.9)kcal/kg/day, p < 0.001). The REE in the ICU and ward was >110% of HBE-REE from day four onwards. CONCLUSIONS: Critically ill mechanically ventilated patients were shown to have a resting energy expenditure (REE) > 110% of predicted REE on ICU admission day four and thereafter. Indirect calorimetry measurements suggest that the mean energy requirements during post-ICU hospitalization are higher than those in the ICU.