Gait speed is a valid measure of both physical function and vestibular health.Vestibular rehabilitation is useful to improve gait speed for patients with vestibular hypofunction,yet there is little data to indicate ho...Gait speed is a valid measure of both physical function and vestibular health.Vestibular rehabilitation is useful to improve gait speed for patients with vestibular hypofunction,yet there is little data to indicate how changes in gait speed reflect changes in patient-reported health outcomes.We determined the minimal clinically important difference in the gait speed of patients with unilateral vestibular hypofunction,mostly due to deafferentation surgery,as anchored to the Dizziness Handicap Index and the Activities Balance Confidence scale,validated using regression analysis,change difference,receiveroperator characteristic curve,and average change methods.After six weeks of vestibular rehabilitation,a change in gait speed from 0.20 to 0.34 m/s with 95%confidence was required for the patients to perceive a significant reduction in perception of dizziness and improved balance confidence.展开更多
Purpose: To compare and examine motor and cognitive functions in people who require support, and in healthy elders. Method: The variables of age, BMI, educational background, blood pressure, grip strength, knee extens...Purpose: To compare and examine motor and cognitive functions in people who require support, and in healthy elders. Method: The variables of age, BMI, educational background, blood pressure, grip strength, knee extension, gait speed, MMSE, and subjective health feeling for 36 rehabilitation users and 22 healthy elders were assessed. We compared and examined motor and cognitive functions in rehabilitation users who need support and healthy elders. Results: The percentage of MMSE scores with 27 points or higher and that of subjective health feeling with 3 points or higher were significantly higher in healthy elders than in rehabilitation users. Systolic and diastolic blood pressure were significantly higher in rehabilitation users than in healthy elders. Gait speed and MMSE scores were significantly higher in healthy elders than rehabilitation users. Conclusion: Gait speed could be used for physical fitness in elders. Gait speed was the best physical fitness measurement for elders. Gait speed of rehabilitation users was strongly related to MMSE scores. Gait speed could be a determinant of MMSE scores.展开更多
AIM:To assess the association of measured gait speed with hemodialysis(HD)patients’hospitalization,in conjunction with,and apart from,recent fall history.METHODS:Gait speed was measured by a standard protocol and fal...AIM:To assess the association of measured gait speed with hemodialysis(HD)patients’hospitalization,in conjunction with,and apart from,recent fall history.METHODS:Gait speed was measured by a standard protocol and falls during the past 12 mo were ascertained for a prevalent multi-center HD cohort(n=668)aged 20-92.Hospitalization during the past 12 mo was identified in the patient’s clinic records,and the first hospitalization after gait speed assessment(or the competing event of death)was identified in the 2013 United States Renal Data System Standard Analysis Files.RESULTS:Slow gait speed,defined as<0.8 m/s,characterized 34.7%of the patients,and 27.1%had experienced a recent fall.Patients with slow gait speed but without a history of recent falls were 1.79 times more likely to have been hospitalized during the past12 mo(OR=1.79,95%CI:1.11-2.88,P=0.02),and patients with slow gait speed and a history of recent falls were over two times more likely to have been hospitalized(OR=2.10,95%CI:1.19-3.73,P=0.01),compared with patients having faster gait speed and no recent fall history.Prospective examination of gait speed/fall history status in relation to first hospitalization(or death)incurred by the end of follow-up December 31,2011 also showed that slow gait speed was associated with these events in conjunction with a history of falls(HR=1.54,95%CI:1.04-2.30,P=0.03).CONCLUSION:The International Task Force on Nutrition and Aging reported that gait speed is a powerful predictor for older adults of adverse outcomes such as hospitalization.In our data,gait speed--apart from,as well as in conjunction with,recent fall history--was associated with HD patients’hospitalization for multiple causes.Gait speed may be a sensitive health indicator among HD patients across the age spectrum.展开更多
Purpose: This study investigates the existence of a correlation between the gait speed and kinesthetic sense in lower legs and to conduct further analysis of kinesthetic sense in relation to the risk of fall among com...Purpose: This study investigates the existence of a correlation between the gait speed and kinesthetic sense in lower legs and to conduct further analysis of kinesthetic sense in relation to the risk of fall among community dwelling females aged 65 years or older. Materials and Methods: A non-experimental correlational, descriptive, and cohort study included 38 community dwelling females (average age of 82.5 years). The kinesthetic ruler (K-Ruler) and kinesthetic test protocol were created and used to assess lower extremity kinesthetic awareness. The GaitRite System was used to assess gait speed. Each subject was categorized into four groups: “LL” (Low K-Score and low gait speed), “LH” (Low K-Score and high gait speed), “HL” (High K-Score and low gait speed), and “HH” (High K-Score and high gait speed) according to kinesthetic awareness and gait speed measured. Voluntary fall incidence reporting over the 6-month period was followed by the initial data collection. Results: Pearson product-moment correlation (2-tailed) showed that there is a statistically significant, positive moderate-to-strong correlation between K-score and gait speed (ICC = 0.692, p Discussion: Gait speed declines as kinesthetic awareness of lower extremity decreases in community dwelling 65 or older female subjects. Additionally, the combination of kinesthetic awareness and gait speed can be served as a predictor of fall risk. The K-ruler can be used to assess lower extremity kinesthetic awareness in older people as a feasible and standard test.展开更多
Aims: Epidemiologic evidence suggests that physical activity is associated with reduced risk of Type 2 diabetes. Walking is simple, effective, and by far the most prevalent physical activity among older adults. Howeve...Aims: Epidemiologic evidence suggests that physical activity is associated with reduced risk of Type 2 diabetes. Walking is simple, effective, and by far the most prevalent physical activity among older adults. However, it is difficult to recognize and evaluate performance-based parameters of physical activity. The purpose of this study was to evaluate the importance of performance-based gait speed among several physical measurements in the development of Type 2 diabetes using long-term community-based data on elderly Japanese persons. Methods: 10 baseline physical measurements, including habitual (HGS) and fast (FGS) gait speed, were examined in 102 elderly Japanese persons living independently in the community (mean age: 71.1 years old) who were not previously diagnosed with diabetes. The subjects then participated in a daily exercise program consisting of walking, stretching, muscle strengthening, and balance exercises and were followed for an average of 4.16 years. Using Cox proportional hazards models with adjustment for age, sex, and category of fasting glucose status, we investigated whether gait speed and/or other physical measurements are associated with development of Type 2 diabetes. Results: 9 subjects developed Type 2 diabetes. Among the 10 physical parameters examined, prolongation of HGS and FGS per second was the only statistically significant factors, with hazard ratios 1.83 (1.15 - 2.89, P = 0.010) and 2.93 (1.43 - 6.03, P = 0.003), respectively. Conclusions: We found a negative association between the development of Type 2 diabetes and gait speed among elderly Japanese people. We conclude that encouraging physical activity and preserving walking capacity may be beneficial for preventing Type 2 diabetes.展开更多
Background: The Unified Parkinson’s Disease Rating Scale is the most commonly used scale in the clinical study of Parkinson’s disease. However, it may fail to capture the essence of physical impairment in patients w...Background: The Unified Parkinson’s Disease Rating Scale is the most commonly used scale in the clinical study of Parkinson’s disease. However, it may fail to capture the essence of physical impairment in patients with Parkinson’s disease and thus limit responsiveness of care-givers, patients, and/or clinicians as to increasing physical disability. This study sought to compare subjective measures of physical disability in Parkinson’s disease to an objective, accurate, and proven measure of physical function-gait speed. Methods: Eighty-eight individuals with early to moderate stage Parkinson’s disease were evaluated on the Unified Parkinson’s Disease Rating Scale, the Parkinson’s disease Questionnaire 39 and during five 8 meter walking trials. Spearman correlations coefficients were used to determine the association among all variables of interest. Results: The findings demonstrate that only a fair to moderate relationship between objectively measured gait speed and physical function as measured subjectively by the clinical rating scale and as evaluated by the patients during self report. Conclusions: The results of this study suggest that commonly utilized measures of physical function in Parkinson’s disease are not highly correlated with gait speed. Because gait speed is demonstrated as a dependable proxy for physical function, the results of this study may provide a rational for the use of gait speed to provide a more accurate picture of physical function in patients with Parkinson’s disease.展开更多
基金Michael C Schubert was funded by the Department of Defense under the Neurosensory and Rehabilitation Research Award Program (Grant award#W81XWH-15-1-0442)Lee Dibble was funded by the Telemedicine and Advanced Technology Research Center(TATRC) through the Army Medical Department Advanced Medical Technology Initiative (AAMTI)Brian J.Loyd was supported in part by the Foundation for Physical Therapy Research New Investigator Fellowship Training Initiative (NIFTI).
文摘Gait speed is a valid measure of both physical function and vestibular health.Vestibular rehabilitation is useful to improve gait speed for patients with vestibular hypofunction,yet there is little data to indicate how changes in gait speed reflect changes in patient-reported health outcomes.We determined the minimal clinically important difference in the gait speed of patients with unilateral vestibular hypofunction,mostly due to deafferentation surgery,as anchored to the Dizziness Handicap Index and the Activities Balance Confidence scale,validated using regression analysis,change difference,receiveroperator characteristic curve,and average change methods.After six weeks of vestibular rehabilitation,a change in gait speed from 0.20 to 0.34 m/s with 95%confidence was required for the patients to perceive a significant reduction in perception of dizziness and improved balance confidence.
文摘Purpose: To compare and examine motor and cognitive functions in people who require support, and in healthy elders. Method: The variables of age, BMI, educational background, blood pressure, grip strength, knee extension, gait speed, MMSE, and subjective health feeling for 36 rehabilitation users and 22 healthy elders were assessed. We compared and examined motor and cognitive functions in rehabilitation users who need support and healthy elders. Results: The percentage of MMSE scores with 27 points or higher and that of subjective health feeling with 3 points or higher were significantly higher in healthy elders than in rehabilitation users. Systolic and diastolic blood pressure were significantly higher in rehabilitation users than in healthy elders. Gait speed and MMSE scores were significantly higher in healthy elders than rehabilitation users. Conclusion: Gait speed could be used for physical fitness in elders. Gait speed was the best physical fitness measurement for elders. Gait speed of rehabilitation users was strongly related to MMSE scores. Gait speed could be a determinant of MMSE scores.
基金Supported by National Institutes of Health contract HHSN267200715004C,ADB No.N01-DK-7-5004(Dr.Kutner)
文摘AIM:To assess the association of measured gait speed with hemodialysis(HD)patients’hospitalization,in conjunction with,and apart from,recent fall history.METHODS:Gait speed was measured by a standard protocol and falls during the past 12 mo were ascertained for a prevalent multi-center HD cohort(n=668)aged 20-92.Hospitalization during the past 12 mo was identified in the patient’s clinic records,and the first hospitalization after gait speed assessment(or the competing event of death)was identified in the 2013 United States Renal Data System Standard Analysis Files.RESULTS:Slow gait speed,defined as<0.8 m/s,characterized 34.7%of the patients,and 27.1%had experienced a recent fall.Patients with slow gait speed but without a history of recent falls were 1.79 times more likely to have been hospitalized during the past12 mo(OR=1.79,95%CI:1.11-2.88,P=0.02),and patients with slow gait speed and a history of recent falls were over two times more likely to have been hospitalized(OR=2.10,95%CI:1.19-3.73,P=0.01),compared with patients having faster gait speed and no recent fall history.Prospective examination of gait speed/fall history status in relation to first hospitalization(or death)incurred by the end of follow-up December 31,2011 also showed that slow gait speed was associated with these events in conjunction with a history of falls(HR=1.54,95%CI:1.04-2.30,P=0.03).CONCLUSION:The International Task Force on Nutrition and Aging reported that gait speed is a powerful predictor for older adults of adverse outcomes such as hospitalization.In our data,gait speed--apart from,as well as in conjunction with,recent fall history--was associated with HD patients’hospitalization for multiple causes.Gait speed may be a sensitive health indicator among HD patients across the age spectrum.
文摘Purpose: This study investigates the existence of a correlation between the gait speed and kinesthetic sense in lower legs and to conduct further analysis of kinesthetic sense in relation to the risk of fall among community dwelling females aged 65 years or older. Materials and Methods: A non-experimental correlational, descriptive, and cohort study included 38 community dwelling females (average age of 82.5 years). The kinesthetic ruler (K-Ruler) and kinesthetic test protocol were created and used to assess lower extremity kinesthetic awareness. The GaitRite System was used to assess gait speed. Each subject was categorized into four groups: “LL” (Low K-Score and low gait speed), “LH” (Low K-Score and high gait speed), “HL” (High K-Score and low gait speed), and “HH” (High K-Score and high gait speed) according to kinesthetic awareness and gait speed measured. Voluntary fall incidence reporting over the 6-month period was followed by the initial data collection. Results: Pearson product-moment correlation (2-tailed) showed that there is a statistically significant, positive moderate-to-strong correlation between K-score and gait speed (ICC = 0.692, p Discussion: Gait speed declines as kinesthetic awareness of lower extremity decreases in community dwelling 65 or older female subjects. Additionally, the combination of kinesthetic awareness and gait speed can be served as a predictor of fall risk. The K-ruler can be used to assess lower extremity kinesthetic awareness in older people as a feasible and standard test.
文摘Aims: Epidemiologic evidence suggests that physical activity is associated with reduced risk of Type 2 diabetes. Walking is simple, effective, and by far the most prevalent physical activity among older adults. However, it is difficult to recognize and evaluate performance-based parameters of physical activity. The purpose of this study was to evaluate the importance of performance-based gait speed among several physical measurements in the development of Type 2 diabetes using long-term community-based data on elderly Japanese persons. Methods: 10 baseline physical measurements, including habitual (HGS) and fast (FGS) gait speed, were examined in 102 elderly Japanese persons living independently in the community (mean age: 71.1 years old) who were not previously diagnosed with diabetes. The subjects then participated in a daily exercise program consisting of walking, stretching, muscle strengthening, and balance exercises and were followed for an average of 4.16 years. Using Cox proportional hazards models with adjustment for age, sex, and category of fasting glucose status, we investigated whether gait speed and/or other physical measurements are associated with development of Type 2 diabetes. Results: 9 subjects developed Type 2 diabetes. Among the 10 physical parameters examined, prolongation of HGS and FGS per second was the only statistically significant factors, with hazard ratios 1.83 (1.15 - 2.89, P = 0.010) and 2.93 (1.43 - 6.03, P = 0.003), respectively. Conclusions: We found a negative association between the development of Type 2 diabetes and gait speed among elderly Japanese people. We conclude that encouraging physical activity and preserving walking capacity may be beneficial for preventing Type 2 diabetes.
文摘Background: The Unified Parkinson’s Disease Rating Scale is the most commonly used scale in the clinical study of Parkinson’s disease. However, it may fail to capture the essence of physical impairment in patients with Parkinson’s disease and thus limit responsiveness of care-givers, patients, and/or clinicians as to increasing physical disability. This study sought to compare subjective measures of physical disability in Parkinson’s disease to an objective, accurate, and proven measure of physical function-gait speed. Methods: Eighty-eight individuals with early to moderate stage Parkinson’s disease were evaluated on the Unified Parkinson’s Disease Rating Scale, the Parkinson’s disease Questionnaire 39 and during five 8 meter walking trials. Spearman correlations coefficients were used to determine the association among all variables of interest. Results: The findings demonstrate that only a fair to moderate relationship between objectively measured gait speed and physical function as measured subjectively by the clinical rating scale and as evaluated by the patients during self report. Conclusions: The results of this study suggest that commonly utilized measures of physical function in Parkinson’s disease are not highly correlated with gait speed. Because gait speed is demonstrated as a dependable proxy for physical function, the results of this study may provide a rational for the use of gait speed to provide a more accurate picture of physical function in patients with Parkinson’s disease.
