The Effects of Walking Poles and Training on Gait Characteristics and Fear of Falling in Community Dwelling Older Adults

BACKGROUND & PURPOSE: Walking poles are becoming popular not only in younger populations, but also with older adults. Manufacturers are promoting the health benefits of walking poles and claim that they facilitate a more normal gait pattern and increase confidence with walking in older adults. There is a lack of evidence to support these claims. The purpose of this double-blinded randomized controlled trial involving community dwelling older adults is twofold: 1) to measure the impact of walking poles on gait speed, stride length, and fear of falling; and 2) to compare the impact of walking pole use between a structured pole training group and an unstructured pole training group. METHODS: Dynamic gait analysis was performed on 12 healthy subjects (mean age 84.5 +/- 9.5 years; 8 female/4 males) using a GAITRite® mat. To determine baseline, subjects performed three walking trials without walking poles. Subjects were then randomly assigned to one of two groups, either structured or unstructured, for training in the use of walking poles. The subjects then repeated three walking trials on the GAITRite® mat utilizing the walking poles. Gait speed, stride length, fear of falling, and global rating of change within and between groups was analyzed using paired t-tests, independent 2 sample t-tests, Spearman correlations and Pearson correlations. RESULTS: When comparing walking with and without walking poles, significant differences (p\u3c0.05) were found within the unstructured training group with gait speed and stride length while no significant differences were found within the structured training group. No significant differences were found between training groups when comparing the amount of change in gait speed and stride length. A moderate inverse correlation was found between change scores of gait speed and fear of falling. CONCLUSION: Results did not support the hypothesis that the use of walking poles would impact gait speed, stride length, and fear of falling differently in subjects who participated in structured training as compared to those who did not participate in structured training. Regardless of the type of training, our research did not support advertisers’ claims that walking poles improve gait speed, stride length, or confidence with walking

Hearing threshold and physical performance in older people: a cross-sectional study from the HUNT4 cohort

Purpose: To evaluate the association between increased hearing loss and reduced physical performance in older people. Methods: Cross-sectional population-based study using data from the fourth wave of the Trøndelag Health Survey (HUNT4) in Norway. Data were obtained from the subproject HUNT4 Hearing which collected audiometric data of people > 70 years (N = 13,197). Analyses were performed on all participants who had completed audiometry and measured balance using the Short Physical Performance Battery (SPPB), which was scored from 0 (worst score) to 12. The hearing threshold was expressed as a pure tone average (PTA). Associations between the hearing threshold for the best and worst ear and physical performance were analyzed by linear regression models adjusted for age, sex, education, diabetes, and cardiovascular disease. Hearing threshold was indicated with steps of 10 dB. Results: Of 13,197 eligible participants, 4101 who completed audiometry and SPPB (52.3% women. mean age 76.3 years) were included. The analyses revealed an association between reduced SPPB and increased hearing threshold in the best ear (b = − 0.296; 95% CI − 0.343 to − 0. 249; P < 0.001) and the worst ear (b = − 0.229; 95% CI − 0.270 to − 0.189; P < 0.001). Conclusions: In this population study, we found that the increased hearing threshold was associated to reduced physical performance as measured by SPPB. The association seemed to be strongest for the best ear. The association between hearing threshold and physical performance illustrates the importance of assessing physical performance in people with hearing loss to prevent the risk of falls and disability. The underlying causes of the associations between hearing loss and poorer physical performance are not fully understood and should be further investigated. Level of evidence: Level 3.publishedVersio

Marine biodiversity in temperate Western Australia: Multi-taxon surveys of minden and Roe Reefs

A growing body of evidence indicates that temperate marine ecosystems are being tropicalised due to the poleward extension of tropical species. Such climate mediated changes in species distribution patterns have the potential to profoundly alter temperate communities, as this advance can serve to push temperate taxa, many of which are southern Australian endemics, southward. These changes can lead to cascading effects for the biodiversity and function of coastal ecosystems, including contraction of ranges/habitats of sensitive cool water species. Hence there is growing concern for the future of Australia's temperate marine biodiversity. Here we examine the diversity and abundance of marine flora and fauna at two reefs near Perth's metropolitan area-Minden Reef and Roe Reef. We report the presence of 427 species of marine flora and fauna from eight taxon groups occurring in the Perth metropolitan area; at least three species of which appear to be new to science. Our data also extends the known range of 15 species, and in numerous instances, thousands of kilometres south from the Kimberley or Pilbara and verifies that tropicalisation of reef communities in the Perth metropolitan area is occurring. We report the presence of 24 species endemic to south-west Australia that may be at risk of range contractions with continued ocean warming. The results of these surveys add to our knowledge of local nearshore marine environments in the Perth metropolitan area and support the growing body of evidence that indicates a diverse and regionally significant marine fauna occurs in temperate Western Australia. Regular, repeated survey work across seasons is important in order to thoroughly document the status of marine biodiversity in this significant transition zone