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PubMed2001

[Effect of rheumatoid arthritis on physical performance of patients].

To determine the changes occurRing in physical performance of patients with RA, 188 patients have been observed over a ten-year period. The observation included two groups: the test group comprising 93 patients with RA who have never been treated by any disease-modifying antirheumatic drugs (DMARDs) and the control group comprising 95 patients with RA who have regularly taken DMARDs under the rheumatologist's supervision. The average age of the test group was considerably higher, there were more retired persons with a prolonged course of illness, their physical performance being more intensely affected than that of the control group. Further analysis during the observation period showed significant decrease of physical performance in both groups regardless of their being treated or not by the DMARDs which, in our opinion, only modify the illness. To conclude, irrespective of the application of the DMARDs, RA is undoubtedly an illness with considerable socio-economic significance since it leads to great physical disability (invalidity) of all RA patients.

Activities of Daily Living↗

PubMed1997

The effect of chronic diseases on physical function. Comparison between activities of daily living scales and the Physical Performance Test.

AIM: to verify the capacity of basic and instrumental activities of daily living (BADL and IADL) disability scales and of a performance-based test (Physical Performance Test; PPT) to detect the effect on the functional capacity of several common chronic conditions in elderly people. METHOD: a cross-sectional survey of the entire population aged 70 and over, living in Ospitaletto (Brescia, northern Italy)-549 subjects; 89.6% of the eligible population; 179 males and 370 females-was carried out in 1992. A multi-dimensional questionnaire administered at the subject's home was used to collect information on demographics, presence of several common chronic diseases and BADL and IADL. Objective physical capacity was assessed using the PPT. RESULTS: only cognitive deterioration and depression were independently associated with disability, as detected by BADL or IADL scales. Cognitive deterioration, stroke, parkinsonism, heart disease and hearing and visual loss were independently associated with PPT. The performance at PPT remained statistically associated with most of the same diseases when the analysis was restricted to subjects with no BADL or IADL disability. CONCLUSION: a performance-based measure, such as PPT, may detect a functional limitation before it becomes measurable by traditional self-reported BADL and IADL scales.

Activities of Daily Living↗

PubMed1998

Psychometric characteristics and clinical usefulness of physical performance tests in patients with low back pain.

STUDY DESIGN: The psychometric properties and clinical use of a battery of physical performance measures were tested on 44 patients with low back pain and 48 healthy, pain-free control subjects. OBJECTIVES: Reliability, validity, and clinical use of nine physical performance measures were evaluated. SUMMARY OF BACKGROUND DATA: Although physical performance measures have potential use in evaluation, treatment planning, and determination of treatment outcome, there is sparse systematic investigation of their reliability, validity, and clinical use. METHODS: Forty-four subjects with low back pain and 48 healthy pain-free subjects participated. The following physical performance measures were tested: distance walked in 5 minutes; 50-foot walk at fastest speed; 50-foot walk at preferred speed; 5 repetitions of a sit-to-stand task; 10 repetitions of a repeated trunk flexion task; timed up-and-go task; unloaded forward reach task; loaded forward reach task; and Sorensen fatigue test. Subjects were assessed twice on 2 days. RESULTS: All measures had excellent intertester reliability (intraclass correlation coefficient [ICC]1,1 > 0.95). Test-retest (within session) reliability was adequate for all measures (ICC1,1 > 0.83) except repeated trunk flexion (ICC1,1 > 0.45) in the low back pain group. Test-retest (day-to-day) reliability ranged between 0.59 and 0.88 in the low back pain group and between 0.46 and 0.76 in the control group. Day-to-day reliability improved when the averages of two trials of repeated trunk flexion and sit-to-stand were used (0.76-0.91 low back pain group and 0.62-0.89 control group). Results of a multivariate analysis of variance showed a significant effect of group (F10,65 = 3.52, P = 0.001). Results of univariate analyses showed significant group differences on all measures except the 50-foot walk at preferred speed and unloaded forward reach. Self-report of disability was moderately correlated with the performance tasks (r = 0.400 to -0.603). CONCLUSIONS: The results provide support for the use of these physical performance measures as a complement to patient self-report.

Activities of Daily Living↗

PubMed2004

Functional limitations and poor physical performance as independent risk factors for self-reported fractures in older persons.

OBJECTIVE: This study examined whether three aspects of functioning (i.e., functional limitations, physical performance, and physical activity) were associated with fractures in older men and women. DESIGN: A 3-year prospective cohort study. PARTICIPANTS AND SETTING: A total of 715 men and 762 women, aged 65 years and older, of the population-based Longitudinal Aging Study Amsterdam. MEASUREMENTS: During an interview at home, three aspects of functioning were assessed: functional limitations (what people say they can do), physical performance, i.e., three performance tests and handgrip strength (what people are able to do), and physical activity (what people actually do). Afterward, a follow-up on fractures was conducted for 3 years. RESULTS: 77 patients (5.2%) suffered a fracture during 3-year follow-up. Most patients suffered a hip fracture (1.6%) or a wrist fracture (1.4%). The fracture rate per 1,000 person-years was 20.1. During 3-year follow-up, a fracture was reported by 12%, 10%, 12%, and 6% of the respondents with functional limitations, low performance test score, poor handgrip strength, and low physical activity, respectively. Using Cox proportional hazard analysis, functional limitations (RR = 3.5; 95% CI, 2.1 to 6.0), low performance test score (RR = 1.9; 95% CI, 1.1 to 3.3), low handgrip strength (RR = 2.5; 95% CI, 1.5 to 4.1), and low physical activity (RR = 1.9; 95% CI, 1.1 to 3.5) were significantly associated with fractures after adjustment for age and sex. Functional limitations (RR = 3.2; 95% CI, 1.8 to 5.5), low performance test score (RR = 1.8; 95% CI, 1.0 to 3.3) and low handgrip strength (RR = 2.0; 95% CI, 1.1 to 3.6) remained significantly associated with fractures after additional adjustment for body composition, chronic diseases, psychosocial factors, life style factors, and the other levels of functioning. No significant interaction terms were found. CONCLUSIONS: Functional limitations and poor physical performance were independent risk factors for fractures.

Activities of Daily Living↗

PubMed2002

Changes in physical performance in elderly Europeans. SENECA 1993 - 1999.

OBJECTIVE: To assess longitudinal changes in subjective and objective measures of physical performance in elderly Europeans. DESIGN: Longitudinal study including SENECA measurements 1993-1999. SETTING: Data were collected in 9 'traditional' European towns. SUBJECTS AND METHODS: In total 444 men and women, born 1913-1918 participated both in the follow-up survey in 1993 and in the finale in 1999. Changes in Activities of Daily Living (ADL), the 7 item Physical Performance Test (PPT) and in the ability to perform the chair stand and the tandem test were measured. RESULTS: ADL and PPT did not change significantly between the 2 surveys, while participants needed more time to perform the chair stand (p<0.02) and their balance declined according to the tandem test (p< 0.01). Men were significantly better than women, in all measures of physical performance. However, the decline in functioning was of the same magnitude. All tests showed significant variation between centres in physical function. Significant cross cultural variation was found for changes in the capacity to perform the objective tests. Tests of distributions showed good association between the self reported and objective measures of physical performance. Rather than assessing the same task in several ways, the measures may reflect different levels of disability, and as such be important end point measures. CONCLUSIONS: Both ADL and objective tests of simple functions applied well in the SENECA population. Physical performance declines with age. Across European towns variation in physical performance was identified.

Activities of Daily Living↗

PubMed2005

Physical performance limitations and participation restrictions among cancer survivors: a population-based study.

PURPOSE: Medical late effects among cancer survivors may result in impairments that limit physical performance and activities necessary for normal participation in daily life. The aim of this analysis was to estimate the prevalence of physical performance limitations and participation restrictions among recent (< 5 years since diagnosis), and long-term (> or = 5 years) cancer survivors. METHODS: Data from the 1999-2002 National Health and Nutrition Examination Survey were analyzed to compare the proportions of physical performance limitations and participation restrictions among 279 recent and 434 long-term cancer survivors, and among 9370 persons with no reported cancer history. Multivariable logistic regression was used to calculate adjusted prevalence odds ratios. RESULTS: Physical performance limitations were 1.5-1.8 times (53% versus 21%) and participation restrictions 1.4-1.6 times (31% versus 13%) more prevalent in cancer survivors than in those with no cancer history. Recent cancer history was associated with increased prevalence of physical performance limitation and participation restriction, particularly in survivors aged 40-49 years. CONCLUSIONS: Over half of the cancer survivors reported physical performance limitations; one third reported participation restrictions. Deficits were present many years following cancer diagnosis, even among survivors who were not elderly. Cancer survivors may benefit from evaluation for rehabilitation services long after treatment for their original disease.

Activities of Daily Living↗

PubMed2006

Lower extremity physical performance and use of compensatory strategies for mobility.

OBJECTIVES: To compare measured lower extremity physical performance in the clinic with the methods used to carry out mobility tasks at home and to identify key factors influencing day-to-day task performance. DESIGN: Cross-sectional analysis of the Women's Health and Aging Study I. SETTING: Community-dwelling female residents of Baltimore, Maryland. PARTICIPANTS: One thousand two cognitively intact women aged 65 and older with moderate to severe physical limitations. MEASUREMENTS: Compensatory strategies reportedly used for mobility in the home, distinguishing between use of no compensatory strategies, behavioral changes only, durable medical equipment (DME) with or without behavioral change, and human help; measured lower extremity (LE) physical performance (gait speed, timed chair stands, balance). RESULTS: There was a statistically significant difference in LE physical performance between women using the four types of compensatory strategy (P < .001). Women who used DME for mobility in the home had worse performance than those using human help who in turn had worse performance than those with behavioral changes only; women reporting no compensatory strategies for in-home mobility performed best. Sequential multivariate logistic regressions identified several factors other than LE physical performance that were associated with use of specific compensatory strategies. Medical conditions, education, and environmental barriers influenced whether compensatory strategies were used at all, whereas income, contact with health providers, and availability of help in the home influenced the type of compensatory strategy. CONCLUSION: Physical abilities are an important factor influencing use of compensatory strategies for mobility, but several other factors also influence the ways that women adapt to mobility limitations.

Activities of Daily Living↗

PubMed2004

Physical performance and Darwinian fitness in lizards.

Strong evidence for a genetic basis of variation in physical performance has accumulated. Considering one of the basic tenets of evolutionary physiology--that physical performance and darwinian fitness are tightly linked--one may expect phenotypes with exceptional physiological capacities to be promoted by natural selection. Why then does physical performance remain considerably variable in human and other animal populations? Our analysis of locomotor performance in the common lizard (Lacerta vivipara) demonstrates that initial endurance (running time to exhaustion measured at birth) is indeed highly heritable, but natural selection in favour of this trait can be unexpectedly weak. A manipulation of dietary conditions unravels a proximate mechanism explaining this pattern. Fully fed individuals experience a marked reversal of performance within only one month after birth: juveniles with low endurance catch up, whereas individuals with high endurance lose their advantage. In contrast, dietary restriction allows highly endurant neonates to retain their locomotor superiority as they age. Thus, the expression of a genetic predisposition to high physical performance strongly depends on the environment experienced early in life.

Aging↗

PubMed2005

Testosterone, dehydroepiandrosterone, and physical performance in older men: results from the Massachusetts Male Aging Study.

OBJECTIVE: This manuscript examines the relationships of total testosterone (T), bioavailable T, dehydroepiandrosterone (DHEA), and DHEA sulfate (DHEAS) to measures of physical performance in a large, population-based, random sample of men. METHODS: In the most recent wave of the Massachusetts Male Aging Study, measures of strength and physical performance [seven-item physical performance test (PPT), timed chair stand test, and grip strength] were made in 684 men, aged 55-85 yr. Complete hormone data were also obtained. Initial graphical exploration of performance outcomes as a function of hormone levels showed linear increases in physical performance up to certain threshold hormone concentrations, beyond which the associations were diminished. Regression models were used to estimate threshold locations and standardized regression coefficients quantifying the association between hormones and strength. RESULTS: All hormones exhibited significant age-adjusted positive association with PPT score below, but not necessarily above, the thresholds. DHEA was positively associated with chair stand score below, but was not above the threshold. None of the hormones studied was significantly associated with grip strength. CONCLUSION: Up to certain critical concentrations, elevated levels of TT, total T, bioavailable T, DHEA, and DHEA sulfate are associated with increased physical performance, as indicated by the PPT. However, levels beyond those critical concentrations, as might be achieved through exogenous supplementation, do not appear to confer any additional benefit. In general, hormone concentrations do not appear to be meaningfully associated with grip strength or chair stand scores.

Adult↗

PubMed2002

[Effects of an optimized exercise therapy on physical performance of patients with cystic fibrosis].

Regular exercise training can increase the physical performance of patients with cystic fibrosis (CF). However, training is often hampered by negative factors such as infections, lack of time, etc. The aim of the present study was to investigate the effects of a 3-week-training-program performed under favourable conditions on physical performance and lung function of CF-patients: 17 patients daily trained at least 2,5 h under suspicious conditions at a sport hotel in Israel (Eilat). During the entire 3 weeks a comprehensive care was applied to the patients including intensive physical therapy and nutrition adapted to the individual demands. Testings of lung function and cycle ergometry ramp tests were performed a week before and after the training program. Additional control measurements were taken 7 months post training. After the 3-week-training vital capacity and FEV1 were increased by 7 % and 6 % (p > 0.05). The results of the cycle ergometry showed bigger and significant improvements in the maximal values of power (12 % - 20 %), oxygen uptake and ventilation. This findings were also valid for the submaximal exercise range indicated by a slower heart rate slope and a lower aerobic-anaerobic threshold. The present results suggest, that relatively large increases in physical performance can be obtained by short, but intensive exercise training including a comprehensive care.

Cystic Fibrosis↗

PubMed2002

Influence of racial origin and skeletal muscle properties on disease prevalence and physical performance.

Skeletal muscle properties are related to disease (e.g. obesity) and physical performance. For example, a predominance of type I muscle fibres is associated with better performance in endurance sports and a lower risk of obesity. Disease and physical performance also differ among certain racial groups. African Americans are more likely than Caucasians to develop obesity, diabetes mellitus and hypertension. Empirical studies indicate that aerobic capacity is lower in African Americans than Caucasians. Because genetics is a partial determinant of skeletal muscle properties, it is reasonable to assume that skeletal muscle properties vary as a function of race. As such, genetically determined and race-specific skeletal muscle properties may partially explain racial disparities in disease and physical performance. However, additional research is needed in this area to enable the development of more definitive conclusions.

Black People↗

PubMed2004

Anemia is associated with disability and decreased physical performance and muscle strength in the elderly.

OBJECTIVES: To examine the association between anemia and disability, physical performance, and muscle strength in older persons. DESIGN: Cross-sectional. SETTING: Community-dwelling older persons in the Chianti area in Italy. PARTICIPANTS: A total of 1,156 persons aged 65 and older participating in the InChianti Study ("Invecchiare in Chianti," i.e., Aging in the Chianti Area). MEASUREMENTS: Anemia was defined according to World Health Organization criteria as a hemoglobin concentration below 12 g/dL in women and below 13 g/dL in men. Disability in six basic and eight instrumental activities of daily living was assessed. Physical performance was assessed using the short physical performance battery (4-m walk, balance, and chair stands), which yields a summary performance score ranging from 0 to 12 (high). Muscle strength was determined using knee extensor and handgrip strength assessments. RESULTS: Overall, 11.1% of the men and 11.5% of the women had anemia. After adjustment for age, sex, body mass index, Mini-Mental State Examination score, creatinine level, and presence of various comorbid conditions, anemic persons had more disabilities (1.71 vs 1.04, P=.002) and poorer performance (8.8 vs 9.6, P=.003) than persons without anemia. Anemic persons also had significantly lower knee extensor strength (14.1 vs 15.2 kg, P=.02) and lower handgrip strength (25.3 vs 27.1 kg, P=.04) than persons without anemia. Further adjustment for inflammatory markers (interleukin-6, C-reactive protein, tumor necrosis factor-alpha) did not change these associations. CONCLUSION: Anemia is associated with disability, poorer physical performance, and lower muscle strength. Further research should explore whether treating anemia has a beneficial effect on the functional status of older persons.

Activities of Daily Living↗

PubMed2025

Impact of Muscle Quality on Muscle Strength and Physical Performance Beyond Muscle Mass or Diabetes Status.

BACKGROUND: Muscle quality, represented by myosteatosis, is recognized as an important factor in sarcopenia. In this study, we aimed to determine the associations between myosteatosis, muscle strength and physical performance among the elderly South Korean population. METHODS: We included 1440 participants (mean age 62.7 ± 6.2 years) from the Korean Genome and Epidemiology Study (KoGES). Based on the computed tomography attenuation of mid-thigh imaging, the total muscle area (TMA), normal-attenuation muscle area (NAMA), low-attenuation muscle area (LAMA) and inter-intramuscular adipose tissue (IMAT) and its indices were used to evaluate myosteatosis. Muscle strength was evaluated using hand grip strength, whereas physical performance was evaluated through 4-m gait speed, a 30-s sit-to-stand test and 2-min walking test. RESULTS: Of the 1440 patients, 51.5% were women, and 37.2% had diabetes. With aging, the LAMA index gradually increased, and the NAMA index gradually decreased in both men and women (p for trend < 0.001). The NAMA index was positively associated, whereas the LAMA and IMAT indices were negatively associated with muscle strength and physical performance after adjusting for age and sex. Higher tertiles of the NAMA index were consistently associated with improved physical performance across all appendicular skeletal muscle tertiles. The relationship between the NAMA index or LAMA index and muscle strength and physical performance did not differ according to diabetic status. Regular exercise was associated with a higher NAMA index and a lower LAMA index in the non-diabetic group; however, no significant difference in muscle quality was observed in the diabetic group in relation to exercise. CONCLUSIONS: Reduced myosteatosis was positively associated with greater muscle strength and better physical performance in both men and women, regardless of muscle mass or diabetes status; improving myosteatosis may be a therapeutic target for the prevention of sarcopenia.

Humans↗

PubMed2003

Benzodiazepine use and physical performance in community-dwelling older women.

OBJECTIVES: To determine whether benzodiazepine use in older women increased the risk of decline in physical function. DESIGN: A four-year prospective cohort study. SETTING: The communities of Iowa and Washington counties, Iowa. PARTICIPANTS: Eight hundred eighty-five women aged 70 and older who had completed physical performance tests in 1988 and 1992. MEASUREMENTS: Benzodiazepine use was determined during in-home interviews and classified by dose, duration, indication for use, and half-life. Physical performance tests included an assessment of standing balance, walking speed (8-foot distance), and repeated chair raises. RESULTS: Ninety (10.2%) reported benzodiazepine use at baseline. After adjustment for baseline physical performance score and potential confounders, benzodiazepine use was associated with a greater decline in physical performance over 4 years than nonuse (beta=-1.16; standard error (SE)=0.25; P<.001). The use of higher-than-recommended dose was related to decline (beta=-2.26; SE=0.47; P<.001), and use of lower doses was not (beta=-0.53; SE=0.46; P=.246). Long-term use (>or=3 years) was related to decline (beta=-1.65; SE=0.34; P<.001), whereas recent and past use were not. Similar results were obtained when restricting the sample to those without disability at baseline. CONCLUSION: This study provides evidence that older women who used benzodiazepines were at risk for decline in physical performance. Subgroup analyses indicated that risk was greater with use of higher-than-recommended doses or for long duration (>or=3 years). These findings highlight the importance of using benzodiazepines at the lowest effective dose for a limited duration in older women.

Activities of Daily Living↗

PubMed1991

Revascularization of infarcted vs. viable myocardium. Effects on symptoms, physical performance and global/regional left ventricular function.

Symptoms, physical performance and global vs. regional left ventricular (LV) function were reviewed in 25 patients with postinfarction anterior-apical akinesia and minor dyskinesia who subsequently underwent revascularization of all graftable stenotic vessels. The observed postoperative improvement in functional NYHA capacity and physical performance was not related to significant change in any systolic or diastolic variable of global LV function. 'Nonspecific postoperative septal hypokinesia' developed in most cases. The regional ejection fraction showed slight (nonsignificant) mean increase in the infarcted apex and low anterior wall supplied by the left anterior descending artery, but marked increase in the noninfarcted lateral wall supplied by the left circumflex branch. Hearts with grafted left circumflex artery showed on average lower preoperative and postoperative ejection fraction in the lateral wall than did hearts without such grafting, but the rise in regional ejection fraction was significant only after left circumflex grafting. The clinical response to coronary artery surgery is attributed mainly to functional improvement of non-infarcted myocardium. Revascularization of viable myocardium occurs directly via bypass grafts, but collateral vessels may also contribute.

Adult↗

PubMed1995

[The circulatory system in children with cutaneous forms of scleroderma. The results of routine as well as 24-hour ECG and physical performance test].

Thirty-four children suffering from so-called cutaneous forms of scleroderma were studied (physical examination, routine and 24-hour ECG, and physical performance test). Physical development was significantly impaired in 5 cases. Congenital heart malformations with left-to-right shunt were detected in 3 children. These children underwent surgery with good results. Heart murmur was found during physical examination in 14 cases. In 30 subjects routine ECG was described as abnormal or doubtful. Abnormal Holter monitoring results were found in 13 children. The authors were not able to detect inferior physical performance test results in the studied children as compared to the control group (when the children suffering from congenital heart malformations and resting tachycardia were excluded from the study). It is suggested that children suffering from so-called cutaneous forms of scleroderma should remain under constant cardiological care.

Adolescent↗

PubMed1979

[Bone maturity and physical performance].

We have examined the relation between physical performance (as measured with the CAHPER tests), bone age (Greulich and Pyl's wrist evaluation) and dental age (Garn's method). Our study included 164 boys and 149 girls aged from 7 to 11. In spite of interesting significant simple correlation between most of the CAHPER tests and bone age measurements for the pre-pubescent period, the latter remains of negligible value in predicting physical performance in the studied children when variables like chronological age, body height and body weight are already included in the prediction equation.

Age Determination by Skeleton↗

PubMedDate not supplied

Modeling growth and senescence in physical performance among the ache of eastern Paraguay.

This article seeks to partially fill a paucity of available data on physical performance in hunter-gatherer societies. Quantitative data are presented on various physical performance measures conducted on the Ache of eastern Paraguay, hunter-gatherers up to the 1970s and now part-time foragers and horticulturists. The performance battery was conducted on most individuals over 10 years of age, allowing for cross-sectional examination of growth and senescence patterns across the lifespan for both sexes. These measures tend to display steep ascents and peak in the early 20s with slight declines thereafter with age for males, whereas females demonstrate peaks in performance earlier in life, with lower or no senescence rates thereafter. The result is a convergence in physical performance between men and women at later ages. We suggest that the female physiology faces reproductive constraints to performance early in life but shifts allocation to increased work output later in life during the long human postmenopausal stage. In contrast, the male physiology maximizes work output in early adult life. These schedules of physical performance are contrasted with schedules of food production ability, which tend to occur later in life, and therefore imply that skill rather than strength alone is an important component of the human foraging niche.

Adolescent↗