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PubMed2006

Effects of vitamin D supplementation and exercise training on physical performance in Chilean vitamin D deficient elderly subjects.

The aim was to assess the effects of resistance training and vitamin D supplementation on physical performance of healthy elderly subjects. Ninety-six subjects, aged 70 years or more with 25 OH vitamin D levels of 16 ng/ml or less, were randomized to a resistance training or control group. Trained and control groups were further randomized to receive in a double blind fashion, vitamin D 400 IU plus 800 mg of calcium per day or calcium alone. Subjects were followed for nine months. Serum 25 OH vitamin D increased from 12.4+/-2.2 to 25.8+/-6.5 ng/ml among subjects supplemented with vitamin D. Trained subjects had significant improvements in quadriceps muscle strength, the short physical performance test and timed up and go. The latter improved more in trained subjects supplemented with vitamin D. At the end of the follow up, gait speed was higher among subjects supplemented with vitamin (whether trained or not) than in non-supplemented subjects (838+/-147 and 768+/-127 m/12 min, respectively, p=0.02). Romberg ratio was lower among supplemented controls than non-supplemented trained subjects (128+/-40% and 144+/-37%, respectively, p=0.05). In conclusion, vitamin D supplementation improved gait speed and body sway, and training improved muscle strength.

Aged↗
PubMed2004

Measuring physical performance via self-report in healthy young adults.

Discrepancies exist in literature as to what extent self-reporting can replace performance-based testing. To answer this question, self-reports and performance tests should measure identical constructs. Previous studies did not measure identical constructs. The objective of our study was to investigate to what extent self-reporting can replace performance-based testing. Seventy-two healthy subjects were tested. The constructs of the self-reports and the performance tests covered the same components to enable a comparison of self-reports and performance test results. Three different self-reports and a performance test were used to measure physical performance. Additionally, rating of perceived exertion was measured after the subjects lifted a reference weight to predict maximal lifting performance. The controls were age, gender, educational level, subject's participation in fitness, availability of reference data, motivation, attitude, general self-efficacy, and mood. Results showed that all lifting tasks could be predicted, though not solely via self-reporting. A prediction of the performance test results with a margin of +/-5 kg of error could be made for at least 79% of the subjects, via gender, self-reporting, and subject's participation in fitness. Self-reporting may not replace performance testing, although performance testing can be predicted with a margin of error of +/- 5 kg for at least 79% of the healthy subjects.

Adult↗
PubMed1993

Development and validation of a physical performance instrument for the functionally impaired elderly: the Physical Disability Index (PDI).

Article describes development of the Physical Disability Index (PDI), an observer-administered, performance-based instrument measuring physical disability in frail-elderly persons without severe cognitive impairment. Sixty-five items in four subscales encompassing Range of Motion (ROM), Strength (STR), Balance (BAL), and Mobility (MOB) were measured. Subjects were randomly selected frail nursing home residents (N = 103) with a Folstein Mini-Mental State Exam (MMSE) score of > or = 11. Using correlation matrices, cluster analysis, and regression techniques, the scale was reduced to 54 items. All individual item values were standardized and aggregated into subscale and summary PDI scores, each with a range of 0-100. Test-retest and interrater reliability were evaluated. Discriminant and convergent validity were established using MMSE, Physical Self-Maintenance Scale (PSMS), and Sickness Impact Profile-Physical Dimension (SIP-PD). PDI is a performance-based instrument that appears to discriminate among frail individuals with differing levels of physical function. Further testing is warranted in other populations of frail-elderly persons to ascertain its applicability and generalizability.

Activities of Daily Living↗
PubMed1992

[Physical performance and sedation: comparative study of the effects of a benzodiazepine (temazepam) and of a non-benzodiazepine hypnotic (zolpidem)].

It is well-known that many athletes experience some form of precompetition stress that may result in insomnia during the night before their competition. Yet, sleep withdrawal even if only partial, has a negative influence on performance, particularly when the type of exercise requires good psychomotor performance The purpose of the present study was to investigate whether the intake of a hypnotic drug would have negative effects on physical performance capacity. The authors have compared the effects of oral temazepam, a medium half-life benzodiazepine vs oral zolpidem, a short half-life non-benzodiazepine drug, vs placebo. A randomized double-blind trial was used to assess endurance, resistance, strength and coordination in 26 athletes. The results did not show any differences between the three groups, neither in physical performance characteristic nor in coordination. It is concluded that as regards the performance capacity, there is no risk for stressed athletes to use sleep inducers the night before their competition.

Adult↗
PubMed2006

Effect of family style mealtimes on quality of life, physical performance, and body weight of nursing home residents: cluster randomised controlled trial.

OBJECTIVE: To assess the effect of family style mealtimes on quality of life, physical performance, and body weight of nursing home residents without dementia. DESIGN: Cluster randomised trial. SETTING: Five Dutch nursing homes. PARTICIPANTS: 178 residents (mean age 77 years). Two wards in each home were randomised to intervention (95 participants) or control groups (83). INTERVENTION: During six months the intervention group took their meals family style and the control group received the usual individual pre-plated service. MAIN OUTCOME MEASURES: Quality of life (perceived safety; autonomy; and sensory, physical, and psychosocial functioning), gross and fine motor function, and body weight. RESULTS: The difference in change between the groups was significant for overall quality of life (6.1 units, 95% confidence interval 2.1 to 10.3), fine motor function (1.8 units, 0.6 to 3.0), and body weight (1.5 kg, 0.6 to 2.4). CONCLUSION: Family style mealtimes maintain quality of life, physical performance, and body weight of nursing home residents without dementia. TRIAL REGISTRATION: Clinical trials NCT00114582.

Aged↗
PubMed1989

Physical performance measures in aging research.

Evaluation of physical functioning plays a valuable role in clinical geriatrics as well as in aging research. Physical functioning has generally been assessed through self- or proxy-report. An important addition to this form of assessment is the use of performance measures of physical function, in which individuals are asked to actually perform specific tasks and are evaluated using standardized criteria. Although there has been limited methodological work on physical performance instruments, this approach offers a number of potential advantages. Several performance assessments have been developed that correlate highly with other measures of health status and predict need for long-term care and mortality. It is suggested that more widespread use be made of physical performance assessments and that they be evaluated as measures of functioning in cross-national studies, as indicators of change in functioning over time, as endpoints in intervention studies, as tools for identifying persons functioning at high levels, and as sources of relevant information for the clinician.

Activities of Daily Living↗
PubMed2003

Effects of vitamin D supplementation on strength, physical performance, and falls in older persons: a systematic review.

OBJECTIVES: identify, appraise, and synthesize data from randomized, controlled trials of vitamin D supplementation in older people. DESIGN: A systematic review of trials identified from searches of databases, reference lists, review articles, and recent conference proceedings. SETTING: Most studies performed in ambulatory setting. PARTICIPANTS: Older people (mean age=60). INTERVENTIONS: Vitamin D or vitamin D metabolites. MEASUREMENTS: Strength, physical performance, or falls. RESULTS: Thirteen trials involving 2,496 patients met this study's inclusion criteria. Most of the trials were small and had methodological problems. In 10 trials, there was no evidence that vitamin D or vitamin D metabolites had an effect on falls or physical function, but three trials showed a positive effect of vitamin D in combination with calcium. When available data from the four highest quality trials were pooled (n=1,317), there continued to be no evidence that vitamin D reduced the risk of falling (relative risk= 0.99, 95% confidence interval=0.89-1.11), although a single trial of vitamin D and calcium showed a positive effect. CONCLUSION: Although there is insufficient evidence that vitamin D supplementation alone improves physical performance in older people, some data suggest a benefit from vitamin D combined with calcium supplementation, but this requires confirmation in large, well-designed trials.

Accidental Falls↗
PubMed2003

Associations of hormone replacement therapy with bone structure and physical performance among postmenopausal women.

The purpose of this cohort study was to focus on factors associated with bone mass and structure of lower limbs and physical performance after menopause. Eighty nonsmoking women with a mean age of 62.1 (SD 0.8) years participated in the study. They were classified into two groups by their use of hormone replacement therapy (HRT), either the current users (n = 43) or the never or discontinued users (n = 37). The tibial shaft and distal tibia were scanned with peripheral computed tomography. For the shaft region, the bone mineral content (BMC, g), cortical density (CoD, g/cm(3)), cortical area (CoA, mm(2)), and section modulus (BSI, mm(3)) were determined. For the distal part, the evaluated variables were BMC, total area (ToA), ratio of cortical to total area (CoA/ToA), trabecular density (TrD, g/mm(3)), cortical thickness, BSI, and buckling ratio. Isometric and dynamic muscle strength of the leg extensors, agility and postural sway, and cardiorespiratory capacity (VO(2max)) were measured. Unadjusted values for all bone variables were slightly higher among the HRT users compared to nonusers, with the exception of TrD with no difference. After controlling for body weight, the mean differences (95% confidence interval) remained significant for CoD of the tibial shaft and BSI of the distal tibia, the mean between-group differences being 1.5% (0.4 to 2.5%) and 23.0% (7.1 to 41.3%), respectively. Underlying the greater bending strength, HRT users had thicker cortices and a greater ratio of CoA/ToA. No differences existed between the two study groups for lower limb isometric or dynamic power, cardiorespiratory capacity, or postural balance or sway. HRT may offer protection against bone loss and maintain bone strength, although its ability to improve physical performance is not evident.

Bone Density↗
PubMed2005

Disability, pain, psychological factors and physical performance in healthy controls, patients with sub-acute and chronic low back pain: a case-control study.

OBJECTIVE: To compare measures of disability, psychological factors, pain and physical performance in healthy controls, and patients with sub-acute and chronic low back pain. To evaluate the concept of the deconditioning syndrome and to explore factors that may contribute to chronicity. DESIGN: Case-control study. SUBJECTS: Three age- and gender-matched groups were included in the study; healthy controls (n = 45), patients sick-listed 8-12 weeks (n = 46) and patients with chronic low back pain on a waiting list for lumbar instrumented fusion (n = 45). METHODS: Measures of disability, pain, psychological factors, and physical performance were obtained from the 3 groups using validated measures. RESULTS: Gender, age, body weight and height were not significantly different between the groups. Comparable scores were found for self-rated working ability, fear-avoidance beliefs for physical activity and aerobic capacity in the 2 patient groups. Oswestry Disability Index, pain, emotional distress, abdominal and back muscle endurance were significantly different between the 3 groups. Self-efficacy for pain and fear-avoidance beliefs for work was significantly different between the 2 patient groups. CONCLUSION: The results suggest a stepwise deterioration of impairment and disability from healthy controls to patients with chronic low back pain. Most variables distinguished between healthy controls and patients with sub-acute or chronic low back pain. Deconditioning was more related to psychophysical measures of abdominal and back muscle endurance than to cardiovascular fitness. Comparable scores for fear-avoidance and working ability in the 2 patient categories suggest that these factors appear at an early stage and contribute to the transition from acute to chronic low back pain.

Adult↗
PubMed2003

Physical activity and its relationship to physical performance in patients with end stage knee osteoarthritis.

STUDY DESIGN: Cross-sectional observational design. OBJECTIVES: To compare physical activity levels in men and women with end-stage knee osteoarthritis to those of a comparison group and to examine the relationship between physical activity level and physical performance. BACKGROUND: Osteoarthritis of the knee is associated with significant losses in functional performance and high social costs. Although reductions in physical activity are reported, they have not been quantified or explored. METHODS AND MEASURES: Fifty-nine candidates awaiting total knee arthroplasty (TKAC group) and 79 individuals without osteoarthritis (comparison group) participated. Physical activity was assessed using the Voorrips Questionnaire. Performance measures included fast self-paced walk test, timed up-and-go test, and a timed stair performance measure. A subset of subjects completed the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and underwent muscular strength and endurance testing. The effects of gender and group were tested using GLM ANOVA. Pearson product moment correlations were used to examine relationships between the variables. RESULTS: All aspects of physical activity were lower (P<.001) in the TKAC group, with a moderate difference in household score (18%) and a large difference in leisure activities (63%). Unlike the comparison group, modest but significant correlations (r = 0.31-0.33, P<.03) were observed between overall physical activity and performance test scores for the TKAC group. Physical activity was not significantly related to pain reported on the WOMAC or during the performance tasks. CONCLUSIONS: The belief that pain limits the physical activity of patients with severe osteoarthritis requires further investigation. The profound differences between a comparison group and patients with end-stage osteoarthritis in physical activity have critical implications for the well-being and effective treatment of this population.

Activities of Daily Living↗
PubMed1984

Impairment of physical performance after treatment with beta blockers and alpha blockers.

An investigation was made into the effect of various types of beta blockers, an alpha blocker, a combined alpha and beta blocker, and a diuretic on physical performance in a normotensive man. Beta blockers, the alpha blocker, and the combined alpha and beta blocker significantly (p less than 0.001) reduced physical performance. Further studies are needed to confirm these findings in a larger series of subjects.

Adrenergic alpha-Antagonists↗
PubMedDate not supplied

Warming-up and stretching for improved physical performance and prevention of sports-related injuries.

Competitive and recreational athletes typically perform warm-up and stretching activities to prepare for more strenuous exercise. These preliminary activities are used to enhance physical performance and to prevent sports-related injuries. Warm-up techniques are primarily used to increase body temperature and are classified in 3 major categories: (a) passive warm-up - increases temperature by some external means; (b) general warm-up - increases temperature by nonspecific body movements; and (c) specific warm-up - increases temperature using similar body parts that will be used in the subsequent, more strenuous activity. The best of these appears to be specific warm-up because this method provides a rehearsal of the activity or event. The intensity and duration of warm-up must be individualised according to the athlete's physical capabilities and in consideration of environmental factors which may alter the temperature response. The majority of the benefits of warm-up are related to temperature-dependent physiological processes. An elevation in body temperature produces an increase in the dissociation of oxygen from haemoglobin and myoglobin, a lowering of the activation energy rates of metabolic chemical reactions, an increase in muscle blood flow, a reduction in muscle viscosity, an increase in the sensitivity of nerve receptors, and an increase in the speed of nervous impulses. Warm-up also appears to reduce the incidence and likelihood of sports-related musculoskeletal injuries. Improving flexibility through stretching is another important preparatory activity that has been advocated to improve physical performance. Maintaining good flexibility also aids in the prevention of injuries to the musculoskeletal system. Flexibility is defined as the range of motion possible around a specific joint or a series of articulations and is usually classified as either static or dynamic. Static flexibility refers to the degree to which a joint can be passively moved to the end-points in the range of motion. Dynamic flexibility refers to the degree which a joint can be moved as a result of a muscle contraction and may therefore not be a good indicator of stiffness or looseness of a joint. There are 3 basic categories of stretching techniques: (a) ballistic--which makes use of repetitive bouncing movements; (b) static--which stretches the muscle to the point of slight muscle discomfort and is held for an extended period; and (c) proprioceptive neuromuscular facilitation - which uses alternating contractions and stretching of the muscles. Each of these stretching methods is based on the neurophysiological phenomenon involving the stretch reflex.(ABSTRACT TRUNCATED AT 400 WORDS)

Athletic Injuries↗
PubMed2005

Angiotensin-converting enzyme inhibition intervention in elderly persons: effects on body composition and physical performance.

The disablement process is often accompanied by sarcopenia or muscle loss, which is associated with virtually all identified disability risk factors. Clinically, the association between body composition and physical performance has been documented by several studies. However, loss of strength is greater than loss of muscle mass with age implying that the quality of remaining muscle may be reduced. Although there are limited data explaining potential physiological mechanisms that contribute to muscle quality, sarcopenia is frequently associated with fat accumulation, and the percentage of body fat increases with age even if weight does not. However, the relationship between fat and muscle function may not be linear, suggesting that there may be an optimal ratio of lean to fat mass for physical function. There are no definitive pharmacological interventions proven to prevent decline in physical function either by modulating body composition or by other means. One exception may be angiotensin-converting enzyme inhibitors (ACEIs). ACE is an important component of the renin-angiotensin system, the central hormonal regulator of blood pressure. Recent evidence suggests that ACEIs may improve physical function by means of direct effects on body composition in older persons, rather than through its blood-pressure-lowering effects. Clinical and genetic studies in humans and experimental evidence in animals suggest that modulation of the renin-angiotensin system is associated with metabolic and biochemical changes in skeletal muscle and fat, changes that are associated with declining physical function. ACEIs may modulate this process through a variety of molecular mechanisms including their influence on oxidative stress and on metabolic and inflammation pathways. This review describes potential biological mechanisms of ACE inhibition and its contribution to declining physical performance and changing body composition. Promising pharmacoepidemiological studies and experimental evidence in animals suggest that there are appropriate models in which to study this effect.

Aged↗
PubMed2003

Physical performance measures in the clinical setting.

OBJECTIVES: To assess the ability of gait speed alone and a three-item lower extremity performance battery to predict 12-month rates of hospitalization, decline in health, and decline in function in primary care settings serving older adults. DESIGN: Prospective cohort study. SETTING: Primary care programs of a Medicare health maintenance organization (HMO) and Veterans Affairs (VA) system. PARTICIPANTS: Four hundred eighty-seven persons aged 65 and older. MEASUREMENTS: Lower extremity performance Established Population for Epidemiologic Studies of the Elderly (EPESE) battery including gait speed, chair stands, and tandem balance tests; demographics; health care use; health status; functional status; probability of repeated admission scale (Pra); and primary physician's hospitalization risk estimate. RESULTS: Veterans had poorer health and higher use than HMO members. Gait speed alone and the EPESE battery predicted hospitalization; 41% (21/51) of slow walkers (gait speed <0.6 m/s) were hospitalized at least once, compared with 26% (70/266) of intermediate walkers (0.6-1.0 m/s) and 11% (15/136) of fast walkers (>1.0 m/s) (P <.0001). The relationship was stronger in the HMO than in the VA. Both performance measures remained independent predictors after accounting for Pra. The EPESE battery was superior to gait speed when both Pra and primary physician's risk estimate were included. Both performance measures predicted decline in function and health status in both health systems. Performance measures, alone or in combination with self-report measures, were more able to predict outcomes than self-report alone. CONCLUSION: Gait speed and a physical performance battery are brief, quantitative estimates of future risk for hospitalization and decline in health and function in clinical populations of older adults. Physical performance measures might serve as easily accessible "vital signs" to screen older adults in clinical settings.

Aged↗
PubMed1997

Serum insulin-like growth factor I and physical performance in prepubertal Bolivian girls of a high and low socio-economic status.

The aim of the study was to determine if a decrease in serum insulin-like growth factor I (Igf-I) levels under marginal malnutrition is responsible for the lower physical performance of girls of a low socio-economic status (LSES). Girls were selected after physical examination (Tanner's stage 1) and anthropometric measurements (height, body mass or mb, body mass index or BMI = mb height2). Lean body mass mb,1 was measured after skinfold thickness determination; serum IGE-I, by radioimmunoassay; maximal O2 consumption, (VO2max), directly during incremental exercise up to exhaustion; and maximal aerobic power (Wmax), using the force-velocity test. LSES girls (n = 31) had been malnourished in the past and, currently, were suffering from marginal malnutrition: they were smaller (135.2 +/- 5.5 vs 146.1 +/- 4.3 cm), lighter (31.7 +/- 3.9 vs 37.6 +/- 5.0 kg), exhibited a lower mb,1 (24.2 +/- 2.5 vs 27.5 +/- 3.0 kg) but same BMI compared with HSES (high socio-economic status) girls (n = 32). Igf-I levels (27.7 +/- 7.9 vs 34.1 +/- 6.5 nmol.1(-1), VO2max (45.26 +/- 4.72 vs 50.74 +/- 6.02 ml. min-1.kg-1 LBM) and Wmax (6.00 +/- 1.15 vs 8.70 +/- 1.53 W.kg-1 mb,1 were lower in LSES girls. Moreover, the differences in every parameter were not the consequence of the younger age (10.8 +/- 0.9 vs 11.2 +/- 0.6 years) of the LSES girls. Our results provide evidence that the lower Wmax of undernourished prepubertal girls was partly the consequence of alterations in muscle function at the qualitative level, as a result of a decrease in Igf-I levels. Conversely, under normal nutritional conditions, anthropometric characteristics only are explicatory factors for physical performances.

Bolivia↗
PubMed2004

Effects of montelukast and salmeterol on physical performance and exercise economy in adult asthmatics with exercise-induced bronchoconstriction.

STUDY OBJECTIVES: To compare the effect of montelukast and the long-acting beta(2)-agonist salmeterol on cardiopulmonary exercise economy and physical performance in adult patients with asthma during exercise. DESIGN AND PATIENTS: Asthmatic patients (n = 18), aged 18 to 35 years with exercise-induced bronchoconstriction (EIB), using a double-blind, double-dummy cross-over design. Montelukast, 10 mg/d, was compared to inhaled salmeterol, 50 microg bid. The study medication was administered for at least 5 days prior to testing, with a washout period of at least 5 days. Treadmill exercise tests (5.3% inclination, -15 degrees C ambient temperature) were performed at work loads of 80% of maximal oxygen uptake (Vo(2)max) [6 min], rest (4 min), 60% of Vo(2)max (6 min), and finally step increments until exhaustion. MEASUREMENTS AND RESULTS: We investigated parameters of gas exchange, physical performance, and lung function. After montelukast, the oxygen pulse was higher than after salmeterol, at 80% of Vo(2)max (p = 0.035), and 6 min at 60% of Vo(2)max (p = 0.011). Lung function during exercise, running time to exhaustion, Borg score, lactate levels, Vo(2)max, carbon dioxide elimination, minute ventilation, ventilatory equivalents, respiratory exchange ratio, and heart rate were not significantly different between the two treatments. The maximal postexercise fall in FEV(1) from baseline occurred 2 min after run to exhaustion, and was greater after salmeterol than after montelukast: mean, 16.2% (SD, 11.0) vs 10.0% (SD, 12.2) [p < 0.001]. CONCLUSIONS: In adult asthmatics with EIB, montelukast may have a more favorable effect on the oxygen pulse, thus suggesting improved gas exchange during exercise.

Acetates↗
PubMed2000

Lower extremity function and subsequent disability: consistency across studies, predictive models, and value of gait speed alone compared with the short physical performance battery.

BACKGROUND: Although it has been demonstrated that physical performance measures predict incident disability in previously nondisabled older persons, the available data have not been fully developed to create usable methods for determining risk profiles in community-dwelling populations. Using several populations and different follow-up periods, this study replicates previous findings by using the Established Populations for the Epidemiologic Study of the Elderly (EPESE) performance battery and provides equations for the prediction of disability risk according to age, sex, and level of performance. METHODS: Tests of balance, time to walk 8 ft, and time to rise from a chair 5 times were administered to 4,588 initially nondisabled persons in the four sites of the EPESE and to 1,946 initially nondisabled persons in the Hispanic EPESE. Follow-up assessment for activity of daily living (ADL) and mobility-related disability occurred from 1 to 6 years later. RESULTS: In the EPESE, compared with those with the best performance (EPESE summary performance score of 10-12), the relative risks of mobility-related disability for those with scores of 4-6 ranged from 2.9 to 4.9 and the relative risk of disability for those with scores of 7-9 ranged from 1.5 to 2.1, with similar consistent results for ADL disability. The observed rates of incident disability according to performance level in the Hispanic EPESE agreed closely with rates predicted from models developed from the EPESE sites. Receiver operating characteristic curves showed that gait speed alone performed almost as well as the full battery in predicting incident disability. CONCLUSIONS: Performance tests of lower extremity function accurately predict disability across diverse populations. Equations derived from models using both the summary score and the gait speed alone allow for the estimation of risk of disability in community-dwelling populations and provide valuable information for estimating sample size for clinical trials of disability prevention.

Activities of Daily Living↗