Changes in plantar pressure, force and contact area when carrying incremental loads among adults with and without low back pain

Plantar pressure, force and contact area information may provideinsights regarding stresses imparted to the foot when performing functional tasks. There is limited information regarding plantar pressure, force and contact area when carrying incremental loads (no load, 5 kg, 7.5 kg and 10 kg) using one hand between adults with and without low back pain (LBP). The aim of our study was to investigate the changes in the plantar pressure, force and contact area when carrying incremental loads (no load, 5 kg, 7.5 kg and 10 kg) using one hand between adults with and without low back pain (LBP). A total of 20 adults with non-specific LBP and 20 matched individuals without LBP were recruited according to the predefined recruitment criteria. Plantar pressure (PP), maximum force (MF) and contact area (CA were measured in standing position and during walking while carrying incremental loads (no load, 5 kg, 7.5 kg and 10 kg) using their right hand on a Matscan pressure assessment system. A two-way mixed analysis of variance (group× load) was conducted to analyse the data. No significant main effectof group was demonstrated on both the right and left foot during standing (PP: p = 0.74, p = 0.32; MF: p = 0.17, p = 0.67; CA: p = 0.25, p = 0.24) and walking (PP: p = 0.61, p = 0.48; MF: p = 0.19, p = 0.06; CA: p = 0.16, p = 0.26. Similarly, there was no interaction effect between the loads and groups on the PP (p = 0.89, p = 0.47), MF (p = 0.76, p = 0.83) and CA (p = 0.88, p = 0.20) on theright and left foot, respectively during standing. However, a significant interaction effect (p < 0.05), between the loads and groups was demonstrated on the PP, MF and CA on the left foot during walking. The results of our study suggest that stresses imparted to the foot alters during dynamic postures and this may be a compensatory mechanism. Plantar pressure, force and contact area were similar in adults both with and without LBP when standing and walking. Further biomechanical information that includes both kinematic and kinetic data in lumbopelvic and lower limbs in relation to the foot may be required to justify for prevention and management strategies among adults with LBP

WEB PLOT DIGITIZER SOFTWARE: CAN IT BE USED TO MEASURE NECK POSTURE IN CLINICAL PRACTICE?

Objective : The aim of this study was to examine the use of WPD software to evaluate FHP using digital photogrammetry method.Method: A total of 15 adults with no history of neck pain for the past 6 months were recruited for the study. Using digital photogrammetry and sagittal head tilt, craniocervical and shoulder angles (SAs) were measured using a WPD, which is an open resource of web or Windows-based software.Result: Fifteen participants aged 17–40 years (mean 24.7±6.3 years) were examined. Sagittal head tilt and craniocervical angles were 16.35°±8.33° and 47.43°±7.97°, respectively. SA was 52.28°±12.46°.Conclusion: WPD may be used to evaluate FHP in the clinical settings. However, future research is required to determine the validity and reliability of WPD among patients with neck-related musculoskeletal disorders with a larger sample

Physical performance difference in community dwelling older adults with successful ageing, usual ageing and mild cognitive impairment

Physical performance in older adults is known to decline with ageing. However, there is limited information about physical performance difference among older adults with; successful (SA), usual ageing (UA) and mild cognitive impairment (MCI). The purpose of this study was to compare the differences in physical performance among older adults in these three categorised groups. This study is part of a larger scale population based longitudinal study on neuroprotective model for healthy longevity among older adults (LRGS TUA). Physical performance was assessed using hand grip (HGT; upper limb strength), 2 minutes step (2MST; endurance), sit to stand (STS; lower limb strength), sit and reach (SRT; lower body flexibility), timed up and go (TUG; mobility and balance), back scratch (BST; upper body flexibility) and gait speed (GS; walking speed) tests. Cognitive status was measured using Mini Mental Status Examination (MMSE) for global function, Digit Span for attention and working memory; Rey Auditory Verbal Learning Test (RAVLT) for verbal memory. Participants were categorised in three groups; SA, UA and MCI. SA group were those without diabetes, hypertension, chronic lung disease, cancer, heart diseases and stroke, had normal scores in MMSE (score of >22), optimum self-rated health and no functional limitations measured using Instrumental Activities of Daily Living questionnaire (IADL). Participants with MCI had subjective information of cognitive impairment from caretakers, minimum or low functional limitation, global function with ≤ 19 score on MMSE and 1 SD from below the normal mean of the group for Digit Span and RAVLT. Older adults with UA had minimal or no functional limitation and average scores of MMSE, Digit Span and RAVLT which were between the scores of SA and MCI group. Data was collected among 1291 participants in Phase three of LRGS TUA study. Data was analysed for differences among the three groups using one way ANOVA test. The results showed that majority of older adults was categorized as UA group (71.14%), followed by SA (15.19% ) and MCI (12.72%). Higher performance in physical performance measures except in SRT were demonstrated in SA group compared to MCI and UA groups. Post hoc Sheffe test showed that there was a significant difference (p < 0.05) in the SA and UA group for all tests except for HGT and SRT. MCI and UA groups were significantly different (p < 0.05) in STS, TUG and GST tests. The results suggested that UA and MCI groups had reduced physical performance in lower limb muscle strength, mobility, balance and walking speed compared SA group. Promoting optimum physical performance is important among older adults for successful ageing

Gender-specific age-related changes in physical performance, physical activity and anthropometry status among community-dwelling older persons with and without mild cognitive impairment : a prospective study

In this study, we aimed to determine gender specific age-related decline in anthropometry status, physical performance (PP) and physical activity (PA) in older persons with and without mild cognitive impairment (MCI) prospectively over 3 years. Within-group changes across three time points (baseline-Wave 1, 18 months-Wave 2, 36 months-Wave 3) based on gender and cognitive status were determined. Data was collected at Wave 3 of a longitudinal study: “Neuroprotective Model for Health Longevity among Elderly”. Secondary data from Wave 1 and 2 was obtained for analysis. Older persons with MCI were categorised to have subjective memory problems (answered ‘yes’ on item 10 of Geriatric Depression Scale), scored at least 1.5 SD below mean average on Rey Auditory Verbal Learning Test and Digit Span, no dementia, no problems with activities in daily living, intact global cognition (>19/30: Mini Mental State Examination) and without depression (Geriatric Depression Scale 15-items,≤4). Anthropometry measurements and a battery of PP tests were performed. PA was measured using Physical Activity Scale for the Elderly questionnaire. Data from 779 older persons (67.7 ± 5.3 years) consisting of 372 men (68.0 ± 5.2 years) and 407 women (67.4 ± 5.4) who completed all tests from Wave 1 to Wave 3 were analysed. There was a decline in PP (-0.7% to -14.1% per year), PA levels (-0.7% to -14.1% per year) and anthropometry status (-0.1% to -6.3% per year), except for percentage body fat (+9.9% per year) with advancing age. Within-group changes over the three years showed significant differences (p<0.05) in height and PA in non-MCI and MCI men and lower body flexibility in non-MCI and MCI women. Specifically, tailored physical and nutritional health prevention and promotion strategies for older persons based on gender and cognitive status may be beneficial to support person-centered care

Knowledge, attitude, and practice of ergonomics among physiotherapy undergraduates in Malaysia

Ergonomic posture can be defined as neutral positions of the body that is aligned and balanced while either sitting or standing, placing minimal stress on the body and keeping joints aligned. A good posture can help to prevent musculoskeletal disorders (MSDs). However, MSD cases are the most common health problem among physiotherapists including undergraduates. The aim of this study was to identify the knowledge, attitude, and practice of ergonomics among physiotherapy undergraduates in Malaysia. An online survey involving 116 physiotherapists undergraduates from learning institutions all over Malaysia was conducted. All the participants were provided a Google Form comprising 18 questions about demographic data, knowledge, attitude, and practice. The data were analyzed using the frequency table and chi-square test. Out of 116 respondents, 76.72% had good knowledge of ergonomics, almost all the respondents accounting for 96.35% had a positive attitude towards ergonomics, and 82.55% practiced good ergonomics. A statistically significant association was shown between attitude and level of education (p<0.05) and year of study (p<0.05), and knowledge with the year of study (p<0.05). The results showed that physiotherapy undergraduates in Malaysia have good knowledge and positive attitude towards ergonomics and they practiced good ergonomics in their working life

Validity and reliability of falls screening mobile application (FallSA) to inform falls risk among Malaysian community dwelling older adults

Falls is a global health concern due to its many negative consequences in older adults. Early falls screening and prevention is important among older adults. We developed Falls Screening Mobile Application (FallSA) as a self falls screening tool among older adults. FallSA was developed using data of physical performance test, demographic information and questions to inform falls risk from a larger population based longitudinal study on neuroprotective model for healthy longevity among older adults (LRGS TUA). The aim of this study was to determine validity and reliability of FallSA as a self-screening tool to inform falls risk among Malaysian older adults. This cross sectional study was conducted among 91 community dwelling older adults aged 60 years and above. FallSA was validated against Physiological Profile Assessments (PPA), a comprehensive falls risk assessment tool. Participants used FallSA to test their falls risk by repeating the test twice between an hour. Validity and test–retest reliability of FallSA was examined by using Spearman correlation, Kappa, Sensitivity and Specificity, Intra correlation coefficient (ICC), Cronbach alpha and Bland-Altman. Concurrent validity test was significant with moderate correlation rs = 0.518, p < 0.001, moderate agreement K = 0.516, p < 0.001 and acceptable Sensitivity: 80.4% and Specificity: 71.1%. Reliability of FallSA was shown to be good (ICC: 0.948, CI: 0.921-0.966), good internal consistency α = 0.948, p < 0.001 and good agreement was indicated by small mean differences and narrow limits of agreement (LoA). The results of this study suggest that FallSA was a valid and reliable tool to inform falls risk among Malaysian older adults. Further prospective studies are required to determine the accuracy of FallSA to correctly classify older adults into fallers and non-faller groups

Risk factors of urinary incontinence among community dwelling older adults

Urinary incontinence (UI) is a common disorder among older adults, with a global prevalence between 2% to 58%. UI has been associated with social isolation, increased morbidity and reduced quality of life (QoL). The aim of this study was to investigate the sociodemographic, clinical, cognitive and physical function risk factors of UI among Malaysian community dwelling older adults. This study is part of a larger scale population based longitudinal study on neuroprotective model for healthy longevity among older adults (LRGS TUA). A total of 1560 Malaysian community dwelling older adults aged 60 years and above were screened in this phase III LRGS study. Participants sociodemographic and clinical history were obtained. Mini Mental State Examination (MMSE), Rey Auditory Verbal Learning Test (RAVLT) and Digit Span tested cognitive function. Timed Up and Go Test (TUG), Hand Grip Strength Test, Chair Stand Test and Lawton Instrumental Activities of Daily Living tested physical function. The overall prevalence of UI was 15.7% (n = 245) in this study, with 11.8% (n = 88) in men and 19.3% (n = 157) in women. Logistic regression analysis showed that TUG (Adjusted odds ratio [OR], 1.071; 95% confidence interval [CI], 1.02-1.13), MMSE (OR, 0.93; CI, 0.90-0.97), weight (OR, 1.02; CI, 1.00-1.03), and constipation (OR 0.60; CI, 0.46-0.78) (p < 0.005) were significant risk factors of UI. The results indicate, decreased physical and cognitive function; increase in weight and having constipation increased the risk of UI. Maintaining optimum mobility, cognitive function, body weight and constipation prevention are vital in the prevention and management of UI among older adults

Identification of older adults with Sarcopenia: comparison of two methods

To compare the ability of methods based on skeletal muscle index (SMI) and another one by the European Working Group on Sarcopenia in Older People (EWGSOP) based on both muscle mass and physical function in identifying older adults with sarcopenia. Anthropometric measurements and physical performance (hand grip strength and gait speed) were performed. In order to determine the value of SMI, body impedance analysis was also carried out. A total of 426 older adults, mostly women (60.8%) with mean age of 68.4 ± 6.2 years participated in this study. Methods based on SMI and EWGSOP identified 50.5% and 32.2% older adults as sarcopenic respectively. Method based on SMI showed a significantly higher percentage of men (70.7%) were sarcopenic as compared to women (37.5%) (p < 0.05). No such difference was noted for EWGSOP method, with 28.7% of men were sarcopenic as compared to women (34.4%). Binary logistic regression indicated that aged 75 years and above (adjusted odds ratio: 3.3, 95% confidence interval: 1.9 – 5.6) and having arthritis (adjusted odds ratio: 2.5, confidence interval: 1.3 – 4.7) to be associated with sarcopenia as assessed using method recommended by EWGSOP. The lower prevalence of sarcopenia by EWGSOP as compared to SMI may be due to the more comprehensive method by EWGSOP. Further research regarding validation of these two screening methods against a gold standard of screening for sarcopenia is needed in order to identify the best method.

Blood inflammatory markers, anabolic hormone, vitamin D and L-carnitine status according to frailty status among older adults

Frailty is associated with functional decline and reduced ability to cope with physiological challenges. The pathophysiological changes in frailty include inflammation, endocrine disturbances, neuromuscular and immune dysfunction. However, comprehensive information on the relationship between biological markers and frailty is scarce. We aimed to determine the relationship between selected biomarkers and frailty among Malaysian older adults. In this cross sectional study, 600 community dwelling older adults were randomly selected from ten different areas in Klang Valley. A total of 382 participants met the inclusion criteria and consented to the study. Out of these, a subsamples of 91 participants were selected for biomarkers analysis. Frailty was defined using Fried’s criteria. Fasting blood glucose, lipid profile, albumin, selected frailty biomarkers including IL-6, TNF- alpha and IGF-1 and vitamin D together with free L-carnitine and acetyl L-carnitine were analysed. The results showed a significantly higher level of serum IL-6 and TNF-α among participants classified as frail as compared to pre-frail and robust (p<0.05). With respect to nutritional biomarkers, binary logistic regression showed that vitamin D deficiency is associated with three times higher risk of frailty (p<0.05). There was no significant relationship between blood L-carnitines and frailty. Further research is required to explore the relationship between L-carnitine and frailty using different parameters involved in L-carnitine homeostasis such as CPTII enzyme and OCTN2 mutation. In conclusion, frailty was associated with increased level of inflammatory markers and vitamin D deficiency. It is empirical to promote healthy lifestyle or disease management to reduce inflammation and increase vitamin D status as one of the frailty prevention action plan among older adults

Comparison of physical performance between older adult fallers with and without knee osteoarthritis

Knee osteoarthritis (OA) is a common musculoskeletal condition that leads to decreased physical performance and falls among older adults. However, there is limited information comparing physical performances among older adult fallers with and without knee OA. The aim of this study was to compare physical performance between older adult fallers with and without knee OA. Participants were divided into two groups using the clinical diagnosis of knee OA based on National Institute of Health and Care Excellence guidelines; with and without knee OA. Participants performed a battery of physical performance tests that included chair sit and reach, back scratch, dominant handgrip strength, timed up and go (TUG), 30 seconds chair stand and 2 min walk. Independent t-test was used to compare physical performance between groups. Thirteen older adult fallers with knee OA (mean age = 70.92 ± 8.83 years) and 20 older adult fallers without knee OA (76.4 ± 7.92 years) participated in this study. There were no significant differences in sociodemographic profiles and physical performance among older adult fallers with and without knee OA (p > 0.05). However, hamstring flexibility was not within norm in 64% of older adult fallers with knee OA compared to 42% without OA. Physical performance between fallers with and without clinically diagnosed knee OA was similar. Hence, physiotherapy interventions for both groups may be similar and focused on strength and endurance training. In addition, to minimize falls risk and further improve physical performance, hamstring stretching must be emphasized among older adults with knee OA