BACKGROUND: In recent years, there has been a significant increase in the survival rates of cancer patients. However, this has also led to an increase in side effects, such as dyspnoea, which can negatively impact of patients. We propose a programme for re-educating effort. The main objective is to test the effectiveness of this programme in improving respiratory symptoms and functionality in cancer patients.
METHODS: Experimental, prospective, longitudinal, randomised study with a parallel fixed-assignment scheme (CG-IG). The patients were selected from the Medical Oncology Service of the University Hospital Complex of Salamanca (CAUSA), Spain. Two parallel intervention programmes were designed for the two study groups (Conventional Clinical Practice-Effort Re-education Programme). Primary variables: dyspnoea (MRC), functionality (Barthel); secondary variables: physical performance (SPPB) and functional capacity (ECOG) and the socio-demographic variables (age, sex, anatomopathological diagnosis, and number of treatment lines).
RESULTS: The study sample consisted of 182 patients, with 12 excluded, resulting in a final sample size of n = 170. Sex distribution (CG: 52.9% male and 47.1% female; IG: 49.4% male and 50.6% female). The primary oncological diagnosis was lung cancer, and the most frequent tumour stages were III and IV. Statistically significant differences were found between the IG and CG scores (p < 0.001, d = 0.887, 95% CI) and between the IG and CG scores (p = 0.004, d = 0.358, 95% CI), indicating that the IG performed better.
CONCLUSIONS: The results of this study support the beneficial effects of an exercise re-education programme, carried out by an interdisciplinary team in improving the autonomy of oncology patients with dyspnoea.
BACKGROUND: The clinical trial was registered in ClinicalTrials.gov (NCT04186754). (03 September 2019).

OBJECTIVE: This study investigated the association of fear of falling with performance-based physical function and low back pain (LBP) among older adults.
METHODS: Cross-sectional study.
METHODS: Participants were selected via convenient sampling from Iran University orthopaedic and/or physiotherapy outpatient clinics, between March 2022 and April 2023.
METHODS: 140 subjects with and without LBP, aged over 60 years, were included.
METHODS: The Falls Efficacy Scale International was used to measure fear of falling. A baseline questionnaire inquired about LBP. Participants performed the Timed Up and Go, 30 s Sit-To-Stand (30s-STS), single leg stance with open and closed eyes and gait speed tests to assess performance-based physical function. Demographic variables including age, gender and body mass index were considered as potential covariates. Bivariate and multivariable linear regression analyses were used to investigate the associations.
RESULTS: A significant association between fear of falling and the 30s-STS test score (β=-0.30, 95% CI -1.27 to -0.28; p=0.00) and the sex (β=0.31, 95% CI 1.53 to 4.83; p=0.00) was confirmed in multivariable analyses. LBP and other performance-based physical function tests were not associated with a fear of falling.
CONCLUSIONS: Fear of falling was significantly associated with lower extremity muscle function, measured by the 30s-STS test and female gender. Older adults with a fear of falling could benefit from interventions that improve lower extremity muscle function. Also, the observed association between the fear of falling and the female sex confirms the need for effective interventions to reduce the fear of falling among older women.

BACKGROUND: Understanding genetic contributors to sarcopenia (age-related loss of muscle strength and mass) is key to finding effective therapies. Variants of the bradykinin receptor 2 (BDKRB2) have been linked to athletic and muscle performance. The rs1799722-9 and rs5810761 T alleles have been shown to be overrepresented in endurance athletes, possibly due to increased transcriptional rates of the receptor. These variants have been rarely studied in older people or people with sarcopenia.
METHODS: We performed a post hoc sub-study of the Leucine and ACE (LACE) inhibitor trial, which enrolled 145 participants aged ≥70 years with low grip strength and low gait speed. Participants\' blood samples were genotyped for rs179972 using TaqMan and rs5810761 by amplification through Hotstar Taq. Genotypes were compared with outcomes of physical performance and body composition measures.
RESULTS: Data from 136 individuals were included in the analysis. For rs1799722 the genotype frequency (TT: 17, CC: 48, CT: 71) remained in Hardy-Weinberg Equilibrium (HWE p = 0.248). There was no difference between the genotypes for six-Minute Walk Distance (6MWD) or Short Physical Performance Battery (SPPB). Men with the TT genotype had a significantly greater 6MWD than other genotypes (TT 400m vs CT 310m vs CC 314m, p = 0.027), and greater leg muscle mass (TT 17.59kg vs CT 15.04kg vs CC 15.65kg, p = 0.007). For rs5810761, the genotype frequency (-9-9: 31, +9+9: 43, -9+9: 60) remained in HWE (p = 0.269). The +9+9 genotype was associated with a significant change in SPPB score at 12 months (-9-9 0 vs -9+9 0 vs +9+9-1, p<0.001), suggesting an improvement. In men, the -9-9 genotype was associated with lower arm fat (-9-9 2.39kg vs -9+9 2.72kg vs +9+9 2.76kg, p = 0.019).
CONCLUSIONS: In men, the rs1799722 TT genotype was associated with longer 6MWD and greater leg muscle mass, while the rs5810761 -9-9 genotype was associated with lower arm fat mass.

We studied the effect of N1-(2,3,4-trimethoxybenzyl)-N2-{2-[(2,3,4-trimethoxybenzyl)amino]ethyl}-1,2-ethanediamine (compound ALM-802) on the physical performance of mice after acute fatigue. The animals\' performance was assessed on a treadmill. The criterion for assessing exercise tolerance was the length of the distance passed when running on a treadmill until complete fatigue. To assess the actoprotective activity of compound ALM-802, we used a method of stepwise increase in load with an initial running speed of 42 cm/sec and its subsequent increase by 5 cm/sec every 5 min. The maximum speed of movement of the treadmill belt is 77 cm/sec. Animals that received compound ALM-802 (2 mg/kg intraperitoneally), 1 day after acute fatigue, ran a distance to complete fatigue that exceeded that of control mice by 68% (387.9±60.5 and 230.6±29.6 m, respectively, p=0.023). The reference drug trimetazidine (30 mg/kg, intraperitoneally) did not have a significant effect on the distance traveled. Compound ALM-802 helps restore physical performance, i.e. exhibits significant actoprotective activity.

BACKGROUND: Regular physical activity (PA) offers significant health benefits on both short (i.e., emotional well-being) and long term (i.e., fewer hospitalizations) in Youth with Cystic Fibrosis (YwCF). Regardless, evidence on PA levels in YwCF compared to healthy controls (HC) is inconsistent. Additionally, PA is a multidimensional outcome influenced by several factors such as Quadriceps strength and functional performance. Therefore, we aimed to assess whether PA, Quadriceps strength and functional performance differ between YwCF and HC across different age groups (i.e., children and adolescents).
METHODS: YwCF aged 6-17 from two Belgian CF centres and age- and sex-matched HC were recruited. PA was measured with an ActiGraph GT3X + BT during 7 consecutive days. Isometric Quadriceps strength was assessed with a Hand Held Dynamometer and functional performance with a sit-to stand test (STS) and standing long jump (SLJ).
RESULTS: A total of 49 YwCF (44 % male; 11.3 ± 3.3 years) and 49 HC (48 % male; 11.9 ± 3.5 years) were included. On average days, YwCF performed 4 ± 6.4 min less light PA and 7.5 ± 6.7 min less moderate-to-vigorous PA compared to HC (p = 0.04; p = 0.01). The differences in moderate-to-vigorous PA seem more pronounced in children (6-11 years)(p = 0.04). Furthermore, YwCF had similar Quadriceps strength to HC but had lower scores on the STS and SLJ (p = 0.50, p = 0.08; p = 0.02).
CONCLUSIONS: This study shows lower PA levels and functional performance for YwCF, indicating that there is an urgent need for interventions promoting PA in YwCF. PA promotion will become increasingly important in the post modulator area to prevent health risks associated with low PA.

UNASSIGNED: Physical performance tests are predictive of mortality and may screen for certain health conditions (e.g., sarcopenia); however, their diagnostic and/or prognostic value has primarily been studied in age-limited or disease-specific cohorts. Our objective was to identify the most salient characteristics associated with three lower quarter balance and strength tests in a cohort of community-dwelling adults.
UNASSIGNED: We applied a stacked elastic net approach on detailed data on sociodemographic, health and health-related behaviors, and biomarker data from the first visit of the Project Baseline Health Study (N = 2,502) to determine which variables were most associated with three physical performance measures: single-legged balance test (SLBT), sitting-rising test (SRT), and 30-second chair-stand test (30CST). Analyses were stratified by age (<65 and ≥65).
UNASSIGNED: Female sex, Black or African American race, lower educational attainment, and health conditions such as non-alcoholic fatty liver disease and cardiovascular conditions (e.g., hypertension) were consistently associated with worse performance across all three tests. Several other health conditions were associated with either better or worse test performance, depending on age group and test. C-reactive protein was the only laboratory value associated with performance across age and test groups with some consistency.
UNASSIGNED: Our results highlighted previously identified and several novel salient factors associated with performance on the SLBT, SRT, and 30CST. These tests could represent affordable, noninvasive biomarkers of prevalent and/or future disease in adult individuals; future research should validate these findings.
UNASSIGNED: ClinicalTrials.gov, identifier NCT03154346, registered on May 15, 2017.

Whole-body vibration training (WBV) training has shown positive effects on bone strength, muscle strength, and balance, but the evidence on fall prevention is not yet persuasive. This study aimed to evaluate the effectiveness of WBV training in preventing falls and improving physical performance among older adults at fall risk. The study was an assessor- and participant-blinded, randomized, and controlled 10-week training trial with a 10-month follow-up. One hundred and thirty older adults (mean age 78.5 years, 75% women) were randomly allocated into the WBV group (n = 68) and the low-intensity wellness group (n = 62). Falls were prospectively collected using monthly returned and verified diaries. Physical performance was evaluated at baseline before randomization, after the intervention, and follow-up with established methods. The data were analyzed on an intention-to-treat basis. Negative binomial regression was used to estimate the incidence rate ratios for falls, and Cox regression models were used to calculate the hazard ratios for fallers. Between-group differences in physical performance were estimated by generalized linear mixed models. The retention rate was 93%, and the mean adherence to the WBV training was 88% and 86% to the wellness training. Sixty-eight participants fell at least once, and there were 156 falls in total. In the WBV group, the incidence rate of falls was 1.5 (95% confidence interval 0.9 to 2.5) compared to the wellness group (p = 0.11). The hazard ratio for fallers in the WBV group was 1.29 (0.78 to 2.15) (p = 0.32). There was no between-group difference in physical performance after the training period, but by the end of the follow-up, WBV-related benefits appeared. The chair-rising capacity was maintained in the WBV group, while the benefit disappeared in the wellness group (p = 0.004). Also, the 0.5-point difference in short physical performance battery (SPPB) score favored WBV training (p = 0.009). In conclusion, progressive side-alternating WBV training was feasible and well-tolerated among fall-prone older adults. During the one-year follow-up, WBV training was associated with improved physical performance but did not prevent falls compared to chair-based group exercises.

Self-exercise during hemodialysis reportedly prevents functional decline. This study aimed to assess the effects of exercise on physical function during hemodialysis. From September 2014 to March 2018, 35 elderly dialysis patients participated in an exercise program 3 times a week for 24 weeks during hemodialysis under staff supervision. The Short Physical Performance Battery and muscle strength test were used to measure physical function, and the Short Form Version 2 and Self-Rating Questionnaire for Depression were used to measure psychological function. For Short Physical Performance Battery, walking speed and standing time improved significantly. Other significant improvements were observed in both knee extension muscle strength and right side of grip strength. There was also an improving trend in both Short Form Version 2 and Self-Rating Questionnaire for Depression after the intervention compared with the baseline. A long-term supervised self-exercise program during dialysis led to maintenance and improvement of physical and psychological functioning in elderly dialysis patients.

BACKGROUND: As the global population ages and the number of older adults living alone increases, societies face the responsibility of building new support systems and providing novel forms of care to ensure the independence and happiness of sick or frail older individuals. This quasi-experimental study examined the association between information and communication technology-based smart care services and the physical and cognitive functions of older individuals living alone.
METHODS: This study used a suite of smart technologies (artificial intelligence speaker, radar sensor, and personalized exercise App.) and interventions tailored to the initial physical functional scores of the participants. A total of 176 participants were recruited and assigned, with 88 participants in the intervention group and 88 in the control group. The short physical performance battery (SPPB), the digit span test (DST), and the Korean mini-mental state examination (K-MMSE) were used to assess participants before and after 12 weeks.
RESULTS: No significant differences in gender, age, or educational levels were observed between the intervention and control groups. After adjusting for baseline performance, analysis of covariance revealed that the intervention group exhibited better outcomes in the SPPB five-time chair stand score (adjusted score difference: 0.329; P = 0.044) and the backward DST (adjusted score difference: 0.472; P = 0.007), but had lower score of K-MMSE (adjusted score difference: -0.935; P = 0.021), indicating enhanced lower limb muscle strength and cognitive function in working memory.
CONCLUSIONS: ICT-based smart care services, combined with personalized exercise interventions, significantly support the physical and cognitive health of solitary older individuals. This approach highlights the potential of integrating smart technology and targeted physical activity to foster the well-being of the aging population living alone.

Tests of physical function are often thought to measure functioning that is (1) musculoskeletal, and (2) newly declining in adult life. In contrast, this study aimed to: (1) add to evidence that physical-function tests also measure brain function, and (2) test the novel hypothesis that adult physical function is associated with brain function beginning in early childhood. We investigated early childhood brain function and midlife physical function in the Dunedin Study, a 5-decade longitudinal birth cohort (n = 1,037).
Brain function was measured at age 3 using 5 measures which formed a reliable composite (neurological examination, cognitive and motor tests, and temperament ratings). Physical function was measured at age 45 using 5 measures which formed a reliable composite (gait speed, step-in-place, chair stands, balance, and grip strength).
Children with worse age-3 brain function had worse midlife physical function as measured by the age-45 composite, even after controlling for childhood socioeconomic status (β: 0.23; 95% CI: 0.16 to 0.30; p < .001). Worse age-3 brain function significantly predicted slower gait speed, fewer steps-in-place and chair-stands, worse balance, and weaker grip strength.
Children with poorer brain function were more likely to have poorer physical-function scores as adults. In addition to indicating recent musculoskeletal decline, physical-function tests may also provide indications of lifelong, integrated brain-body health. By reconceptualizing the meaning of physical-function scores, clinicians can orient the use of physical-function tests in a more holistic approach to health care.