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Frailty and cardiovascular disease： potential role of gait speed in surgical risk stratification in older adults

Journal of Geriatric Cardiology 2015年第1期12卷 44-56页

作者： Michael A. Chen Harborview Medical Center University of Washington School of Medicine 325 9th Avenue Box 359748 Seattle WA 98104 USA

Frailty is a state of late life decline and vulnerability, typified by physical weakness and decreased physiologic reserve. The epidemiology and pathophysiology of frailty share features with those of cardiovascular disease. gait speed can be used as a measure of frailty and is a powerful predictor of mortality. Advancing age is a potent risk factor for cardiovascular disease and has been associated with an increased risk of adverse outcomes. Older adults comprise approximately half of cardiac surgery patients, and account for nearly 80% of the major complications and deaths following surgery. The ability of traditional risk models to predict mortality and major morbidity in older patients being considered for cardiac surgery may improve if frailty, as measured by gait speed, is included in their assessment. It is possible that in the future frailty assessment may assist in choosing among therapies （e.g., surgical vs. percutaneous aortic valve replacement for patients with aortic stenosis）.

关键词： Cardiac surgery Frailty gait speed Risk scores Risk stratification

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The minimal clinically important difference for gait speed in significant unilateral vestibular hypofunction after vestibular rehabilitation

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Journal of Otology 2023年第1期18卷 15-20页

作者： Isaac B.Thorman Brian J.Loyd Richard A.Clendaniel Leland E.Dibble Michael C.Schubert School of Public Health Department of EpidemiologyJohns Hopkins UniversityUnited States School of Physical Therapy and Rehabilitation Science University of MontanaUnited States Department of Orthopedic Surgery Doctor of Physical Therapy DivisionAnd Department of Head and Neck Surgery&Communication SciencesDuke University Medical CenterUnited States Department of Physical Therapy&Athletic Training University of UtahUnited States Laboratory of Vestibular NeuroAdaptation Department of Otolaryngology e Head and Neck SurgeryJohns Hopkins UniversityUnited States Department of Physical Medicine and Rehabilitation Johns Hopkins UniversityUnited States

gait speed is a valid measure of both physical function and 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 *** 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 *** 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.

关键词： Vestibular hypofunction gait speed Minimal clinically important difference

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gait speed and hospitalization among ambulatory hemodialysis patients: USRDS special study data

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World Journal of Nephrology 2014年第3期3卷 101-106页

作者： Nancy G Kutner Rebecca Zhang Yijian Huang Haimanot Wasse USRDS Rehabilitation/Quality of Life Special Studies Center Emory University Atlanta GA 30322 United States Renal Division Department of Medicine and USRDS Rehabilitation/Quality of Life Special Studies Center Emory University Atlanta GA30322 United States

AIM： To assess the association of measured gait speed with hemodialysis （HD） patients’ hospitalization, in conjunction with, and apart from, recent fall ***： 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 identifed in the 2013 United States Renal Data System Standard Analysis *** 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 past 12 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 frst hospitaliza-tion （or death） incurred by the end of follow-up Decem-ber 31, 2011 also showed that slow gait speed was as-sociated 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 Nutri-tion 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 as-sociated with HD patients’ hospitalization for multiple causes. gait speed may be a sensitive health indicator among HD patients across the age spectrum.

关键词： Falls gait speed Hemodialysis Hospitalization Walking disability

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Correlations between Motor Ability with gait speed and Cognitive Functions in Rehabilitation Users

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Open Journal of Therapy and Rehabilitation 2022年第1期10卷 1-8页

作者： Hiroya Miyabara Seigo Koura Moemi Matsuo Makoto Uchinoura Yuki Kishikawa Yuji Yamaguchi Youhei Komatsu Seijiro Nishimura Shinichi Shibata Hajime Shibata Faculty of Rehabilitation Nishikyusyu University Kanzaki Japan Kurume Rehabilitation Hospital Kurume Japan

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.

关键词： Elderly gait speed Motor Ability Rehabilitation Users The Long-Term Care Insurance

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