BACKGROUND: Sarcopenia leads to functional disability, dependence in activities of daily living (ADL), and is a key contributor to frailty. Reducing and breaking up sedentary time is associated with improved sarcopenia and frailty-related outcomes. The aim of this study was to determine the feasibility of delivering and evaluating a remote sedentary behaviour intervention to improve sarcopenia and independent living in older adults with frailty.
METHODS: A two-arm randomised controlled feasibility trial was conducted with a target of 60 older adults (mean age 74 ± 6 years) with very mild or mild frailty. Participants were randomised to the Frail-LESS (LEss Sitting and Sarcopenia in Frail older adults) intervention or usual care control group for six months. The intervention included tailored feedback on sitting, standing and stepping; an education workbook that included goal setting and action planning; one-to-one health coaching; peer support; and a wearable device to self-monitor sedentary behaviour. Participant recruitment (percentage of eligible individuals recruited), retention and data completion rates were used to assess trial feasibility. Acceptability of the trial was explored through interviews and safety was evaluated via unplanned healthcare utilisation and number of falls. Sitting, standing, stepping and sarcopenia were measured to evaluate potential intervention effects.
RESULTS: Sixty participants were recruited. Recruitment and retention rates were 72% and 83%, respectively. Completion rates for outcome measures ranged from 70 to 100%. The trial was safe (< 1 fall per participant on average at each timepoint) and trial procedures were acceptable. Descriptive analysis (mean ± SD) showed that daily sitting was 25.1 ± 82.1 min/day lower in the intervention group, and 6.4 ± 60.5 min/day higher in the control group, at 6 months compared with baseline. Hand grip strength and sit-to-stand score were improved by 1.3 ± 2.4 kg and 0.7 ± 1.0, respectively, in the intervention group.
CONCLUSIONS: This study demonstrates the feasibility and safety of delivering and evaluating a remote intervention to reduce and break up sitting in older adults with frailty. The intervention showed evidence towards reducing daily sitting and improving sarcopenia, supporting its evaluation in a definitive randomised controlled trial.
BACKGROUND: ISRCTN registry (registration number: ISRCTN17158017). Registered 6th August 2021.

BACKGROUND: Frailty syndrome is prevalent among many patients experiencing intermittent claudication symptoms. Considering that components of the frailty syndrome can affect both physical and psychological functions, it is likely that barriers to physical activity are heightened in these individuals.
OBJECTIVE: To analyze the association between barriers to physical activity and frailty in patients with symptomatic peripheral artery disease (PAD).
METHODS: This cross-sectional study included 216 patients with symptomatic PAD (64.8% men, 65.6±9.4 yrs.). Nine personal and 8 environmental barriers to physical activity were investigated through a questionnaire on barriers to practicing physical activity in patients with intermittent claudication. Frailty was defined according to Fried et al. (2001) criteria which included unintentional weight loss, exhaustion, low grip strength, slow walking speed, physical inactivity. Three or more criteria defined frail, one or 2 criteria defined pre-frail, and absence of criteria defined non-frail. Data are presented as median (interquartile range).
RESULTS: Frail and pre-frail patients have more barriers than non-frail patients [frail: 11 (4); pre-frail: 10 (6); non-frail: 8 (7), p = 0.001]. Absence of a companion for physical activity, lack of knowledge and uncertainty about the benefits of physical activity, pain induced by walking and presence of obstacles that worsen leg pain were associated with frail and pre-frail status, independent of sex, age, ankle-brachial index, and total walking distance.
CONCLUSIONS: Patients with PAD who are frail and pre-frail have more barriers to physical activity than non-frail patients. Therefore, specific interventions promoting PA are essential for these patients to improve their health outcomes.

BACKGROUND: Low physical activity among older adults is related to adverse health outcomes such as depression and loneliness, poor physical function and increased risk of falls. This study was designed to increase physical activity through a digital, group-based, physical activity and music intervention and to examine its effectiveness on social, mental and physical health outcomes.
METHODS: Participants were 34 older adults (65 years +) recruited across four care homes in Scotland to a pilot study. Surveys were administered at baseline and post-intervention, comprising measures of fear of falling, depression and anxiety, loneliness, sleep satisfaction and quality of life. A battery of physical function tests and saliva sampling for cortisol and dehydroepiandrosterone hormone analysis were also conducted at each time point. Additionally, process evaluation measures (recruitment, intervention fidelity, attendance, retention rates and safety) were monitored. The intervention comprised 12 weeks of three prescribed digital sessions per week: movement and music (n = 2) and music-only (n = 1), delivered by an activity coordinator in the care home. Post-intervention interviews with staff and participants were conducted to gain qualitative data on the acceptability of the intervention.
RESULTS: An average of 88% of prescribed sessions were delivered. Pre- to post-intervention intention-to-treat analysis across all participants revealed significant improvements in anxiety, salivary DHEA, fear of falling and loneliness. There were no significant improvements in health-related quality of life, perceived stress, sleep satisfaction or physical function tests, including handgrip strength. Qualitative analysis highlighted benefits of and barriers to the programme.
CONCLUSIONS: The digital movement and music intervention was deemed acceptable and delivered with moderate fidelity, justifying progression to a full-scale trial. Although a proper control group would have yielded more confident causal relationships, preliminary psychosocial and biological effects were evident from this trial. To show significant improvements in physical function, it is likely that a bigger sample size providing sufficient power to detect significant changes, greater adherence, longer intervention and/or higher exercise volume may be necessary.
BACKGROUND: The trial is registered at ClinicalTrials.gov, number NCT05601102 on 01/11/2022.

UNASSIGNED: Unlike other sports, the relationship between performance deficits and pain/injury in lacrosse players has not been well-investigated.
UNASSIGNED: The purposes of this study were to: 1) determine whether age and sex differences exist in dynamic physical function tests and drop jump performance among lacrosse players, and 2) determine whether pre-seasonal physical function scores predict onset of either lower extremity or low back pain over time.
UNASSIGNED: Prospective observational study.
UNASSIGNED: Lacrosse players (N=128) were stratified into three groups: 12-14.9 yrs, 15-18 yrs and >18 yrs. Thomas test (hip flexibility), Ober\'s test (iliotibial band tightness), and Ely\'s test (rectus femoris tightness) were performed. Landing Error Scoring System (LESS) scores were collected while players performed drop jumps. Sagittal and frontal plane movement from 2D video during single and double legged squats was assessed. Musculoskeletal pain symptoms or injury were tracked for six months. Age bracket, sex and physical function scores were entered into logistic regression models to determine risk factors that predicted onset of lower extremity pain and low back pain onset.
UNASSIGNED: LESS scores and single-leg squat movement quality test scores were lowest in the 12-14.9 yr groups and highest in the >18 yr group (all p<0.05). Single leg squat performance score increased the odds risk (OR) for lower extremity pain (OR=2.62 [95% CI 1.06-6.48], p=.038) and LESS scores elevated risk for low back pain onset over six months (OR = 2.09 [95% CI 1.07- 4.06], p= .031).
UNASSIGNED: LESS scores and single legged squat performance may help identify lacrosse players at risk for musculoskeletal pain or injury onset. Detecting these pertinent biomechanical errors and subsequently developing proper training programs could help prevent lower extremity and low back pain onset.
UNASSIGNED: III.

BACKGROUND: Keen Osteoarthritis (KOA) is a common chronic disabling disease characterized by joint pain and dysfunction, which seriously affects patients\' quality of life. Recent studies have shown that transcranial direct current stimulation (tDCS) was a promising treatment for KOA.
OBJECTIVE: Investigate the effects of tDCS on pain and physical function in patients with KOA.
METHODS: Randomized controlled trials related to tDCS and KOA were systematically searched in the PubMed, Embase, Medline, Cochrane Library, CINHL, and Web of Science databases from inception to July 23, 2024. The pain intensity was evaluated using the visual analog scale or the numeric rating scale, and the pain sensitivity was assessed using conditioned pain modulation, pressure pain threshold, heat pain threshold, or heat pain tolerance. The physical function outcome was evaluated using the Western Ontario and McMaster Universities Osteoarthritis Index or the Knee injury and Osteoarthritis Outcome Score. Statistical analysis was performed using Review Manager 5.4.
RESULTS: Seven studies with a total of 503 participants were included. Compared to sham tDCS, tDCS was effective in reducing the short-term pain intensity (SMD: -0.58; 95% CI: -1.02, -0.14; p = 0.01) and pain sensitivity (SMD: -0.43; 95% CI: -0.70, -0.16; p = 0.002) but failed to significantly improve the long-term pain intensity (SMD: -0.26; 95% CI: -0.59, 0.08; p = 0.13) in KOA patients. In addition, tDCS did not significantly improve the short-term (SMD: -0.13; 95% CI: -0.35, 0.08; p = 0.22) and long-term (SMD: 0.02; 95% CI: -0.22, 0.25; p = 0.90) physical function in patients with KOA.
CONCLUSIONS: The tDCS can reduce short-term pain intensity and sensitivity but fails to significantly relieve long-term pain intensity and improve the physical function in patients with KOA. Thus, tDCS may be a potential therapeutic tool to reduce short-term pain intensity and pain sensitivity in patients with KOA.

OBJECTIVE: To evaluate the influence of preoperative VR-12 physical component scores (PCS) on outcomes following cervical disc replacement (CDR).
METHODS: Patients undergoing elective CDR were retrospectively identified. Patient-reported outcomes (PROs) of interest included VR-12 PCS/VR-12 Mental Component Score (MCS)/9-Item Patient Health Questionnaire (PHQ-9)/Short Form-12 (SF-12) PCS and MCS/Patient-Reported Outcome Measurement Information System-Physical Function (PROMIS-PF)/Visual Analog Scale-Neck Pain (VAS-NP)/VAS-Arm Pain (VAS-AP)/Neck Disability Index (NDI). Baseline up to two-year postoperative scores were obtained (average follow-up: 9.2 ± 6.8months). Two cohorts were created: VR-12 PCS < 35 or VR-12 PCS ≥ 35. Improvements in scores from baseline to six weeks postoperatively and to final follow-up were calculated. Changes in scores were compared to previously reported thresholds to determine rates of minimum clinically important difference (MCID).
RESULTS: Of 127 patients, 64 were in the worse VR-12 PCS group. Patients with better VR-12 PCS were more likely to have private insurance (p = 0.034). When accounting for insurance differences, the worse VR-12 PCS group reported inferior NDI/VAS-NP/PHQ-9/PROMIS-PF/VR-12 PCS/SF-12 PCS at six weeks and final follow-up (p ≤ 0.015, all). The worse VR-12 PCS group reported greater improvements in VAS-AP and VR-12 PCS by six weeks and in NDI/VR-12 MCS/VR-12 PCS/SF-12 PCS by final follow-up (p ≤ 0.026, all). Patients with worse VR-12 PCS reported greater MCID achievement for VR-12 MCS and SF-12 PCS (p ≤ 0.034, both).
CONCLUSIONS: Following surgery, patients with worse VR-12 PCS report greater improvements in PROs, highlighting the increased relative impact of surgery for patients with worse baseline physical function. These findings can be used to optimize patient experience perioperatively and inform postoperative expectations.

OBJECTIVE: Physical exercise improves physical and psychological health. However, information on the quantitative impact of Traditional Chinese Exercise (TCE) on physical and psychological health remains limited. Therefore, this systematic review and meta-analysis aimed to quantitatively explore the effects of TCE on the physical and psychological health of patients with multiple sclerosis (MS).
METHODS: A comprehensive search was conducted across seven electronic databases (PubMed, SCOPUS, CINAHL, Web of Science, Cochrane Library, China National Knowledge Infrastructure, and Wanfang) from their inception to March 7, 2024 using the terms, Taiji, Tai Chi, Tai Chi Chuan, Qigong, Baduanjin, Wuqinxi, Yijinjing, multiple sclerosis, and disseminated sclerosis. Randomized controlled trials (RCTs) and non-RCTs reporting the effects of TCE on physical function or psychological health outcomes in MS patients were included. A random-effects model and 95 % confidence intervals (95 % CI) were used to compute the effect sizes.
RESULTS: Eleven studies, including 461 subjects with MS, were included in this meta-analysis. TCE significantly increased balance (d = 0.88, 95 % CI [0.45, 1.31], p < 0.001, I2 = 39.26 %), activities of daily living (d = 1.17, 95 % CI [0.30, 2.04], p < 0.001, I2 = 89.15 %), Multiple Sclerosis Impact Scale (MSIS) scores (d = 0.53, 95 % CI [0.12, 0.93], p = 0.01, I2 = 0 %), depression (d = 0.66, 95 % CI [0.003, 1.32], p = 0.049, I2 = 62.97 %), and Activities-Specific Balance Confidence (ABC) scores (d = 1.30, 95 % CI [0.41, 2.18], p < 0.001, I2 = 0 %) compared with control conditions.
CONCLUSIONS: This meta-analysis suggests the efficacy of TCE in improving balance, activities of daily living, MSIS scores, depression, and ABC scores in MS patients. However, further high-quality research is warranted to investigate these findings.

Lifestyle (diet and exercise) interventions across the cancer care continuum among younger cancer survivors (<60 years of age) demonstrate utility in improving physical function, and other cancer relevant health outcomes. However, the impact of lifestyle interventions on physical function in older (≥60 years) cancer survivors is not entirely clear. This scoping review aims to map and characterize the existing literature on the effect of diet and exercise interventions on physical function in older cancer survivors. Conducted to the JBI Manual for Evidence Synthesis and reported to the PRISMA guidelines, the literature search was performed on multiple databases through March 2024. A total of 19,901 articles were identified for screening with 49 articles published between 2006 and 2024 selected for full-text review. Of these, 36 studies included an exercise intervention, two focused on diet intervention, while 11 studies included both diet and exercise intervention. These 49 studies included various cancer types, cancer stages, and timepoints across the cancer care continuum. Most studies described physical function as their primary outcome and demonstrated maintenance or improvement in physical function. We identified several gaps in the current evidence including lack of (adequately powered) trials focused only on older cancer survivors, and trials focused on dietary interventions alone or dietary interventions combined with exercise interventions within this population vulnerable for nutritional inadequacies and declining physical function. Considering the growing population of older cancer survivors, this represents an important area for further research.

OBJECTIVE: To establish reference values for SPPB score as well as test performances among Taiwanese community-dwelling older adults.
METHODS: Participants included 847 older adults. The total scores and three subtest scores for the SPPB and the registered time to complete the walk and five-repetition sit-to-stand (STS) tests were determined and compared between sex and age (65-74, 75-84, and ≥85 years) groups.
RESULTS: The mean SPPB total score was 10.9 in women and 10.5 in men. SPPB scores did not differ by sex, regardless of age group. However, the walk test (p = .030) and STS test (p = .008) timings were longer for men than for women in the 65-74-year-old group. The ≥85-year-old men achieved a lower balance score than did the 65-74-year-old men (p = .027).
CONCLUSIONS: Population-specific SPPB reference values contribute to assessments of physical function and facilitate cross-cultural comparisons of physical performance.

This epidemiological research investigated the relationship between body mass index (BMI) and lower limb function and community well-being among the older population (≥65 years old) in South Korea. Using the 2020 National Survey of Older Koreans (N = 10 097; Mage = 73.6 ± 6.63; MBMI = 23.6 ± 2.61), the study identified underweight (2.3%), normal (72.8%), and obese (24.9%) groups. Findings revealed significant associations between BMI and lower limb function, with underweight individuals facing greater physical challenges (P < .05-.01). Underweight participants were also found to live farther from key community locations, possibly reflecting social and environmental factors (P < .01) and expressed higher dissatisfaction with community environments (Ps < .05-.01). The study emphasizes the need for tailored community planning and health care strategies, focusing on the unique needs of the underweight older adults, considering South Korea\'s rapidly increasing older population.