Neuromuscular Attributes Associated With Lower Extremity Mobility Among Community-Dwelling Older Adults.
Aged
Ankle Joint
/ physiology
Cross-Sectional Studies
Female
Gait
/ physiology
Geriatric Assessment
Humans
Independent Living
Knee Joint
/ physiology
Lower Extremity
/ physiology
Male
Mobility Limitation
Muscle Strength
/ physiology
Postural Balance
/ physiology
Range of Motion, Articular
/ physiology
Balance
Disablement process
Functional performance
Gait
Rehabilitation
Journal
The journals of gerontology. Series A, Biological sciences and medical sciences
ISSN: 1758-535X
Titre abrégé: J Gerontol A Biol Sci Med Sci
Pays: United States
ID NLM: 9502837
Informations de publication
Date de publication:
14 03 2019
14 03 2019
Historique:
received:
22
11
2017
pubmed:
5
10
2018
medline:
27
12
2019
entrez:
5
10
2018
Statut:
ppublish
Résumé
The Short Physical Performance Battery (SPPB) is advocated as a screening tool in geriatric care for predicting future disability. We aimed to identify the leg neuromuscular attributes to be targeted in rehabilitative care among older adults with poor SPPB scores. Boston Rehabilitative Impairment Study of the Elderly (Boston RISE) participants (n = 430) underwent assessment of neuromuscular attributes (leg strength, leg velocity, trunk extensor endurance, knee flexion range of motion [ROM], ankle ROM, and foot sensation). Linear regression models examined association between each neuromuscular attribute and SPPB, adjusting for age, race, gender, comorbidity, body mass index, depression, cognition, and other neuromuscular attributes. Participants with 1 SD unit higher leg strength, leg velocity, and trunk extensor endurance had 0.52, 0.30, and 0.52 points higher SPPB total score. Participants with ankle ROM impairment and foot sensory loss had 0.43 and 0.57 lower SPPB total score compared with those without these. Leg strength and trunk extensor endurance were associated with balance; leg velocity, trunk extensor endurance, and ankle ROM were associated with gait speed; and strength, trunk extensor endurance, knee ROM, and feet sensation were associated with chair stand score. Neuromuscular attributes, along with covariates, explained 40.4% of the variance in the total SPPB score, a substantial increase over the 22.7% variance explained by covariates alone. Neuromuscular attributes affect mobility performance in older patients as measured by the SPPB. Specific impairments are associated with poor performance in specific component scores. Assessment of the SPPB components and rehabilitation of associated impairments may help improve the functional performance among older adults.
Sections du résumé
BACKGROUND
The Short Physical Performance Battery (SPPB) is advocated as a screening tool in geriatric care for predicting future disability. We aimed to identify the leg neuromuscular attributes to be targeted in rehabilitative care among older adults with poor SPPB scores.
METHODS
Boston Rehabilitative Impairment Study of the Elderly (Boston RISE) participants (n = 430) underwent assessment of neuromuscular attributes (leg strength, leg velocity, trunk extensor endurance, knee flexion range of motion [ROM], ankle ROM, and foot sensation). Linear regression models examined association between each neuromuscular attribute and SPPB, adjusting for age, race, gender, comorbidity, body mass index, depression, cognition, and other neuromuscular attributes.
RESULTS
Participants with 1 SD unit higher leg strength, leg velocity, and trunk extensor endurance had 0.52, 0.30, and 0.52 points higher SPPB total score. Participants with ankle ROM impairment and foot sensory loss had 0.43 and 0.57 lower SPPB total score compared with those without these. Leg strength and trunk extensor endurance were associated with balance; leg velocity, trunk extensor endurance, and ankle ROM were associated with gait speed; and strength, trunk extensor endurance, knee ROM, and feet sensation were associated with chair stand score. Neuromuscular attributes, along with covariates, explained 40.4% of the variance in the total SPPB score, a substantial increase over the 22.7% variance explained by covariates alone.
CONCLUSIONS
Neuromuscular attributes affect mobility performance in older patients as measured by the SPPB. Specific impairments are associated with poor performance in specific component scores. Assessment of the SPPB components and rehabilitation of associated impairments may help improve the functional performance among older adults.
Identifiants
pubmed: 30285233
pii: 5115267
doi: 10.1093/gerona/gly102
pmc: PMC6417482
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, Non-P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
544-549Subventions
Organisme : NICHD NIH HHS
ID : K24 HD070966
Pays : United States
Organisme : NCRR NIH HHS
ID : UL1 RR025758
Pays : United States
Organisme : NIA NIH HHS
ID : R01 AG032052
Pays : United States
Informations de copyright
© The Author(s) 2018. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
Références
J Gerontol A Biol Sci Med Sci. 2000 Apr;55(4):M221-31
pubmed: 10811152
Sports Med. 2013 Jul;43(7):627-41
pubmed: 23568373
Clin Sci (Lond). 1992 Mar;82(3):321-7
pubmed: 1312417
Exp Gerontol. 2014 Sep;57:218-23
pubmed: 24952097
J Gerontol A Biol Sci Med Sci. 2003 Dec;58(12):M1125-34
pubmed: 14684710
J Prev Med Public Health. 2013 Jan;46 Suppl 1:S50-4
pubmed: 23413006
J Am Geriatr Soc. 2003 Mar;51(3):314-22
pubmed: 12588574
J Am Geriatr Soc. 2015 Feb;63(2):315-20
pubmed: 25688606
BMC Fam Pract. 2010 Dec 13;11:98
pubmed: 21144018
J Am Geriatr Soc. 2016 Dec;64(12):2608-2609
pubmed: 27874178
J Gerontol A Biol Sci Med Sci. 2000 Jan;55(1):M43-52
pubmed: 10719772
J Gerontol A Biol Sci Med Sci. 2009 Sep;64(9):983-91
pubmed: 19414509
Arthritis Rheum. 2003 Apr 15;49(2):156-63
pubmed: 12687505
J Gerontol A Biol Sci Med Sci. 2005 Dec;60(12):1546-52
pubmed: 16424286
J Psychiatr Res. 1975 Nov;12(3):189-98
pubmed: 1202204
Cochrane Database Syst Rev. 2009 Jul 08;(3):CD002759
pubmed: 19588334
J Gerontol A Biol Sci Med Sci. 2004 Nov;59(11):1207-12
pubmed: 15602077
Arch Phys Med Rehabil. 2016 Aug;97(8):1316-22
pubmed: 27056644
J Gerontol A Biol Sci Med Sci. 1997 Sep;52(5):M275-85
pubmed: 9310081
J Gerontol A Biol Sci Med Sci. 1996 Nov;51(6):M297-302
pubmed: 8914502
Phys Ther. 1991 Feb;71(2):90-6; discussion 96-7
pubmed: 1989012
Am J Phys Med Rehabil. 2008 Dec;87(12):969-76
pubmed: 19033758
Aging Clin Exp Res. 2010 Oct-Dec;22(5-6):412-8
pubmed: 21422795
Arch Gerontol Geriatr. 2013 Jan-Feb;56(1):141-7
pubmed: 23063093
BMC Med. 2016 Dec 22;14(1):215
pubmed: 28003033
J Gerontol. 1994 Mar;49(2):M85-94
pubmed: 8126356
J Am Geriatr Soc. 2014 Dec;62(12):2273-9
pubmed: 25482096
J Gerontol A Biol Sci Med Sci. 2016 May;71(5):663-9
pubmed: 26369668
J Geriatr Phys Ther. 2009;32(2):46-9
pubmed: 20039582
Diabetes Res Clin Pract. 2001 Nov;54(2):115-28
pubmed: 11640995
PLoS One. 2014 Oct 13;9(10):e110350
pubmed: 25310220
PM R. 2009 Oct;1(10):916-24
pubmed: 19854420
Biogerontology. 2017 Dec;18(6):881-891
pubmed: 27933408
J Aging Phys Act. 2015 Apr;23(2):314-22
pubmed: 24812254
J Gerontol A Biol Sci Med Sci. 2002 Aug;57(8):M539-43
pubmed: 12145369
Aging Clin Exp Res. 2007 Jun;19(3):194-9
pubmed: 17607086
Age Ageing. 1996 Sep;25(5):386-91
pubmed: 8921145
J Gerontol A Biol Sci Med Sci. 2003 Feb;58(2):171-5
pubmed: 12586856
Arch Phys Med Rehabil. 2013 Feb;94(2):347-55
pubmed: 22989700
JAMA. 2014 Jun 18;311(23):2387-96
pubmed: 24866862