Lower-Extremity Force Decrements Identify Early Mobility Decline Among Community-Dwelling Older Adults
Many apparently independent older adults modify daily tasks. Task modifications strongly predict future mobility disability. Clinically intuitive, easily measured "biomarkers" associated with task modifications would offer quantifiable treatment targets for prevention of age-related functi...
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| Veröffentlicht in: | Physical therapy 2012-09, Vol.92 (9), p.1148-1159 |
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| creator | Marko, Moshe Neville, Christopher G Prince, Mark A Ploutz-Snyder, Lori L |
| description | Many apparently independent older adults modify daily tasks. Task modifications strongly predict future mobility disability. Clinically intuitive, easily measured "biomarkers" associated with task modifications would offer quantifiable treatment targets for prevention of age-related functional limitations.
The objective of the study was to examine lower-extremity muscle strength deficits and functionally relevant cutoff points associated with daily task modifications in community dwelling older adults living independently.
This was a cross-sectional observational study.
Fifty-three participants (mean age=76.4 years, SD=5.2) were tested for task modifications and leg strength. Task modifications were assessed using a previously described tool (summary task modification score). Twenty-six of the participants were classified as task modifiers (TM group), and 27 participants were classified as non-task modifiers (NTM group). A net antigravity leg force in the sagittal plane (NETforce) was calculated by summing the normalized isometric and isokinetic torques from the hip extensors, knee extensors, and ankle plantar flexors.
Compared with the NTM group, the TM group exhibited 30.0% and 33.5% reduction in lower-extremity isometric and isokinetic NETforces, respectively. Isometric and isokinetic NETforce cutoff points for task modifications were ≤ 4.24 and 2.77 N · m/kg body weight, respectively. The isometric and isokinetic models both yielded sensitivity and specificity values of 74.1% and 80.8%, respectively (positive likelihood ratio=3.852, 95% confidence interval=1.699-8.735; negative likelihood ratio=0.321, 95% confidence interval=0.167-0.618). Isometric and isokinetic NETforces were significantly associated with task modifications (odds ratio=2.50 and 2.42, respectively).
The cross-sectional design of this study does not allow for a test of causal relationships. This study used a modest yet adequate sample size that may limit generalization of the results.
Isometric and isokinetic NETforce cutoff points provide quantifiable biomarkers that discriminate community-dwelling older adults who modify daily tasks from those who do not. |
| doi_str_mv | 10.2522/ptj.20110239 |
| format | Article |
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The objective of the study was to examine lower-extremity muscle strength deficits and functionally relevant cutoff points associated with daily task modifications in community dwelling older adults living independently.
This was a cross-sectional observational study.
Fifty-three participants (mean age=76.4 years, SD=5.2) were tested for task modifications and leg strength. Task modifications were assessed using a previously described tool (summary task modification score). Twenty-six of the participants were classified as task modifiers (TM group), and 27 participants were classified as non-task modifiers (NTM group). A net antigravity leg force in the sagittal plane (NETforce) was calculated by summing the normalized isometric and isokinetic torques from the hip extensors, knee extensors, and ankle plantar flexors.
Compared with the NTM group, the TM group exhibited 30.0% and 33.5% reduction in lower-extremity isometric and isokinetic NETforces, respectively. Isometric and isokinetic NETforce cutoff points for task modifications were ≤ 4.24 and 2.77 N · m/kg body weight, respectively. The isometric and isokinetic models both yielded sensitivity and specificity values of 74.1% and 80.8%, respectively (positive likelihood ratio=3.852, 95% confidence interval=1.699-8.735; negative likelihood ratio=0.321, 95% confidence interval=0.167-0.618). Isometric and isokinetic NETforces were significantly associated with task modifications (odds ratio=2.50 and 2.42, respectively).
The cross-sectional design of this study does not allow for a test of causal relationships. This study used a modest yet adequate sample size that may limit generalization of the results.
Isometric and isokinetic NETforce cutoff points provide quantifiable biomarkers that discriminate community-dwelling older adults who modify daily tasks from those who do not.</description><identifier>ISSN: 0031-9023</identifier><identifier>EISSN: 1538-6724</identifier><identifier>DOI: 10.2522/ptj.20110239</identifier><identifier>PMID: 22595239</identifier><language>eng</language><publisher>United States: American Physical Therapy Association</publisher><subject>Activities of Daily Living ; Aged ; Analysis ; Body weight ; Care and treatment ; Cross-Sectional Studies ; Disability ; Female ; Geriatric Assessment - methods ; Health aspects ; Humans ; Isometric Contraction - physiology ; Lower Extremity - physiopathology ; Male ; Metabolic disorders ; Methods ; Mobility Limitation ; Muscle Strength - physiology ; Muscle Strength Dynamometer ; Muscle, Skeletal - physiopathology ; Older people ; Patient outcomes ; Physical therapy ; Physically disabled aged ; Physically disabled elderly ; Physiological aspects ; Sensitivity and Specificity ; Studies ; Therapeutics, Physiological ; Torque</subject><ispartof>Physical therapy, 2012-09, Vol.92 (9), p.1148-1159</ispartof><rights>COPYRIGHT 2012 Oxford University Press</rights><rights>COPYRIGHT 2012 Oxford University Press</rights><rights>Copyright AMERICAN PHYSICAL THERAPY ASSOCIATION Sep 2012</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c705t-819e3cdc85a230cc479daa07b893a3303acd308124525930f1e3820019c4aa3d3</citedby><cites>FETCH-LOGICAL-c705t-819e3cdc85a230cc479daa07b893a3303acd308124525930f1e3820019c4aa3d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,27905,27906</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22595239$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Marko, Moshe</creatorcontrib><creatorcontrib>Neville, Christopher G</creatorcontrib><creatorcontrib>Prince, Mark A</creatorcontrib><creatorcontrib>Ploutz-Snyder, Lori L</creatorcontrib><title>Lower-Extremity Force Decrements Identify Early Mobility Decline Among Community-Dwelling Older Adults</title><title>Physical therapy</title><addtitle>Phys Ther</addtitle><description>Many apparently independent older adults modify daily tasks. Task modifications strongly predict future mobility disability. Clinically intuitive, easily measured "biomarkers" associated with task modifications would offer quantifiable treatment targets for prevention of age-related functional limitations.
The objective of the study was to examine lower-extremity muscle strength deficits and functionally relevant cutoff points associated with daily task modifications in community dwelling older adults living independently.
This was a cross-sectional observational study.
Fifty-three participants (mean age=76.4 years, SD=5.2) were tested for task modifications and leg strength. Task modifications were assessed using a previously described tool (summary task modification score). Twenty-six of the participants were classified as task modifiers (TM group), and 27 participants were classified as non-task modifiers (NTM group). A net antigravity leg force in the sagittal plane (NETforce) was calculated by summing the normalized isometric and isokinetic torques from the hip extensors, knee extensors, and ankle plantar flexors.
Compared with the NTM group, the TM group exhibited 30.0% and 33.5% reduction in lower-extremity isometric and isokinetic NETforces, respectively. Isometric and isokinetic NETforce cutoff points for task modifications were ≤ 4.24 and 2.77 N · m/kg body weight, respectively. The isometric and isokinetic models both yielded sensitivity and specificity values of 74.1% and 80.8%, respectively (positive likelihood ratio=3.852, 95% confidence interval=1.699-8.735; negative likelihood ratio=0.321, 95% confidence interval=0.167-0.618). Isometric and isokinetic NETforces were significantly associated with task modifications (odds ratio=2.50 and 2.42, respectively).
The cross-sectional design of this study does not allow for a test of causal relationships. This study used a modest yet adequate sample size that may limit generalization of the results.
Isometric and isokinetic NETforce cutoff points provide quantifiable biomarkers that discriminate community-dwelling older adults who modify daily tasks from those who do not.</description><subject>Activities of Daily Living</subject><subject>Aged</subject><subject>Analysis</subject><subject>Body weight</subject><subject>Care and treatment</subject><subject>Cross-Sectional Studies</subject><subject>Disability</subject><subject>Female</subject><subject>Geriatric Assessment - methods</subject><subject>Health aspects</subject><subject>Humans</subject><subject>Isometric Contraction - physiology</subject><subject>Lower Extremity - physiopathology</subject><subject>Male</subject><subject>Metabolic disorders</subject><subject>Methods</subject><subject>Mobility Limitation</subject><subject>Muscle Strength - physiology</subject><subject>Muscle Strength Dynamometer</subject><subject>Muscle, Skeletal - physiopathology</subject><subject>Older people</subject><subject>Patient outcomes</subject><subject>Physical therapy</subject><subject>Physically disabled aged</subject><subject>Physically disabled elderly</subject><subject>Physiological aspects</subject><subject>Sensitivity and Specificity</subject><subject>Studies</subject><subject>Therapeutics, Physiological</subject><subject>Torque</subject><issn>0031-9023</issn><issn>1538-6724</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqV0s1v0zAUAPAIgVjZuHFGkbiARDp_pYmPVdeNSoVKA86W67xkqZy4sxN1_e95pR1TUYWYfLBs__zk5_ei6B0lQ5YydrnuVkNGKCWMyxfRgKY8T0YZEy-jASGcJhIPzqI3IawIITQT8nV0xlgqU_SDqJy7Dfhk-tB5aOpuG187byC-AoNraLsQzwqc6nIbT7W32_irW9Z2B5HYuoV43Li2iieuafoW95OrDVg8qOKFLcDH46K3XbiIXpXaBnh7mM-jn9fTH5MvyXxxM5uM54nJSNolOZXATWHyVDNOjBGZLLQm2TKXXHNOuDYFJzllIsUMOCkp8JxhWtIIrXnBz6OP-7hr7-57CJ1q6mDwQboF1wdFCc9yycRIIP3wF1253rf4up3KKZdcyCdVaQuqbkvXeW12QdWYEyaISEccVXJCVdCC19a1UNa4feSHJzyOAotgTl74dHQBTQcPXaX7ENTs--0z7Lf_tvnN_F9JHqxx1kIFCus4WRz7z3tvvAvBQ6nWvm603-L_ql3rKmxd9di6yN8f6tEvGyj-4MdefYp3V1d3m9qDCo22FvnvSPviSaakolTk_BeD3_HV</recordid><startdate>20120901</startdate><enddate>20120901</enddate><creator>Marko, Moshe</creator><creator>Neville, Christopher G</creator><creator>Prince, Mark A</creator><creator>Ploutz-Snyder, Lori L</creator><general>American Physical Therapy Association</general><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>8GL</scope><scope>ISN</scope><scope>ISR</scope><scope>3V.</scope><scope>7RQ</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>88E</scope><scope>88I</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2O</scope><scope>M2P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>S0X</scope><scope>U9A</scope><scope>7X8</scope></search><sort><creationdate>20120901</creationdate><title>Lower-Extremity Force Decrements Identify Early Mobility Decline Among Community-Dwelling Older Adults</title><author>Marko, Moshe ; Neville, Christopher G ; Prince, Mark A ; Ploutz-Snyder, Lori L</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c705t-819e3cdc85a230cc479daa07b893a3303acd308124525930f1e3820019c4aa3d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Activities of Daily Living</topic><topic>Aged</topic><topic>Analysis</topic><topic>Body weight</topic><topic>Care and treatment</topic><topic>Cross-Sectional Studies</topic><topic>Disability</topic><topic>Female</topic><topic>Geriatric Assessment - methods</topic><topic>Health aspects</topic><topic>Humans</topic><topic>Isometric Contraction - physiology</topic><topic>Lower Extremity - physiopathology</topic><topic>Male</topic><topic>Metabolic disorders</topic><topic>Methods</topic><topic>Mobility Limitation</topic><topic>Muscle Strength - physiology</topic><topic>Muscle Strength Dynamometer</topic><topic>Muscle, Skeletal - physiopathology</topic><topic>Older people</topic><topic>Patient outcomes</topic><topic>Physical therapy</topic><topic>Physically disabled aged</topic><topic>Physically disabled elderly</topic><topic>Physiological aspects</topic><topic>Sensitivity and Specificity</topic><topic>Studies</topic><topic>Therapeutics, Physiological</topic><topic>Torque</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Marko, Moshe</creatorcontrib><creatorcontrib>Neville, Christopher G</creatorcontrib><creatorcontrib>Prince, Mark A</creatorcontrib><creatorcontrib>Ploutz-Snyder, Lori L</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: High School</collection><collection>Gale In Context: Canada</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Career & Technical Education Database</collection><collection>Nursing & Allied Health Database</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>eLibrary</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Science Database</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>SIRS Editorial</collection><collection>MEDLINE - Academic</collection><jtitle>Physical therapy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Marko, Moshe</au><au>Neville, Christopher G</au><au>Prince, Mark A</au><au>Ploutz-Snyder, Lori L</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Lower-Extremity Force Decrements Identify Early Mobility Decline Among Community-Dwelling Older Adults</atitle><jtitle>Physical therapy</jtitle><addtitle>Phys Ther</addtitle><date>2012-09-01</date><risdate>2012</risdate><volume>92</volume><issue>9</issue><spage>1148</spage><epage>1159</epage><pages>1148-1159</pages><issn>0031-9023</issn><eissn>1538-6724</eissn><abstract>Many apparently independent older adults modify daily tasks. Task modifications strongly predict future mobility disability. Clinically intuitive, easily measured "biomarkers" associated with task modifications would offer quantifiable treatment targets for prevention of age-related functional limitations.
The objective of the study was to examine lower-extremity muscle strength deficits and functionally relevant cutoff points associated with daily task modifications in community dwelling older adults living independently.
This was a cross-sectional observational study.
Fifty-three participants (mean age=76.4 years, SD=5.2) were tested for task modifications and leg strength. Task modifications were assessed using a previously described tool (summary task modification score). Twenty-six of the participants were classified as task modifiers (TM group), and 27 participants were classified as non-task modifiers (NTM group). A net antigravity leg force in the sagittal plane (NETforce) was calculated by summing the normalized isometric and isokinetic torques from the hip extensors, knee extensors, and ankle plantar flexors.
Compared with the NTM group, the TM group exhibited 30.0% and 33.5% reduction in lower-extremity isometric and isokinetic NETforces, respectively. Isometric and isokinetic NETforce cutoff points for task modifications were ≤ 4.24 and 2.77 N · m/kg body weight, respectively. The isometric and isokinetic models both yielded sensitivity and specificity values of 74.1% and 80.8%, respectively (positive likelihood ratio=3.852, 95% confidence interval=1.699-8.735; negative likelihood ratio=0.321, 95% confidence interval=0.167-0.618). Isometric and isokinetic NETforces were significantly associated with task modifications (odds ratio=2.50 and 2.42, respectively).
The cross-sectional design of this study does not allow for a test of causal relationships. This study used a modest yet adequate sample size that may limit generalization of the results.
Isometric and isokinetic NETforce cutoff points provide quantifiable biomarkers that discriminate community-dwelling older adults who modify daily tasks from those who do not.</abstract><cop>United States</cop><pub>American Physical Therapy Association</pub><pmid>22595239</pmid><doi>10.2522/ptj.20110239</doi><tpages>12</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Oxford University Press Journals All Titles (1996-Current); EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | Activities of Daily Living Aged Analysis Body weight Care and treatment Cross-Sectional Studies Disability Female Geriatric Assessment - methods Health aspects Humans Isometric Contraction - physiology Lower Extremity - physiopathology Male Metabolic disorders Methods Mobility Limitation Muscle Strength - physiology Muscle Strength Dynamometer Muscle, Skeletal - physiopathology Older people Patient outcomes Physical therapy Physically disabled aged Physically disabled elderly Physiological aspects Sensitivity and Specificity Studies Therapeutics, Physiological Torque |
| title | Lower-Extremity Force Decrements Identify Early Mobility Decline Among Community-Dwelling Older Adults |
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