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A 37-year-old male ruptured the distal biceps brachii tendon performing a gymnastics routine. At Week 8 postsurgery, a bilateral isokinetic test demonstrated a 64 and 50% (at 60° • s-1and 300° • s-1) peak torque deficit between uninjured and injured arms during elbow flexion. The subject participated in a concentric isokinetic exercise program 3 days a week for 4 months. At 1 year postsurgery a bilateral test demonstrated a 14% deficit in peak torque at 60° • s-1, and faster test velocities of 180° • s-1and 300° • s-1indicated higher torques for the injured biceps muscle. The rehabilitation program returned the ruptured biceps to a level of concentric strength nearly equivalent to the contralateral limb at the velocities tested. © 1995 National Strength & Conditioning Association.
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Introduction: Government and insurance sponsored exercise programs have demonstrated decreased hospitalizations, but it is unclear if this is the case for self-referred programs. Methods: In this retrospective cohort study from 2013 to 2020, older adults who participated for at least three months at a community-based exercise center (participants) were compared with those who did not (nonparticipants). Each completed a baseline physical assessment and periodic reassessments thereafter. These data were paired with regional hospital data and a national mortality database. Statistical analysis and modeling were performed from 2020 to 2023. Survival to all-cause hospitalization was assessed with a priori subgroup comparison by gender and cox proportional hazard modeling by age, gender, and comorbidities. Results: The cohort included 718 adults, mean age 69.5 years (SD 8.4), with 411 (57.2%) participants and 307 nonparticipants. Mean follow-up was 26.7 months. Participants had similar baseline measures of fitness (p>0.05) but were more likely to be retired and less likely to have diabetes or prior stroke than nonparticipants. Sustained participation was associated with a reduced rate of all-cause hospitalization (9.0% vs. 12.7%, p=0.02), even when adjusted (HR 0.54; 95% CI 0.34, 0.87, p=0.01). This decrease was noted only in women (p=0.03) but not in men (p=0.49), gender was nonsignificant after adjustment for comorbidities (p=0.15). Conclusions: Exercise program participation was independently associated with decreased risk of all-cause hospitalization, with possible differential effects by gender. Further randomized trials of the benefits of personalized exercise programs are warranted to assess sex- and gender-specific effects. © 2024 Elsevier Inc.
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Background--Data are sparse regarding the value of physical activity (PA) surveillance among older adults-particularly among those with mobility limitations. The objective of this study was to examine longitudinal associations between objectively measured daily PA and the incidence of cardiovascular events among older adults in the LIFE (Lifestyle Interventions and Independence for Elders) study. Methods and Results--Cardiovascular events were adjudicated based on medical records review, and cardiovascular risk factors were controlled for in the analysis. Home-based activity data were collected by hip-worn accelerometers at baseline and at 6, 12, and 24 months postrandomization to either a physical activity or health education intervention. LIFE study participants (n=1590; age 78.9±5.2 [SD] years; 67.2% women) at baseline had an 11% lower incidence of experiencing a subsequent cardiovascular event per 500 steps taken per day based on activity data (hazard ratio, 0.89; 95% confidence interval, 0.84-0.96; P=0.001). At baseline, every 30 minutes spent performing activities ≥500 counts per minute (hazard ratio, 0.75; confidence interval, 0.65-0.89 [P=0.001]) were also associated with a lower incidence of cardiovascular events. Throughout follow-up (6, 12, and 24 months), both the number of steps per day (per 500 steps; hazard ratio, 0.90, confidence interval, 0.85-0.96 [P=0.001]) and duration of activity ≥500 counts per minute (per 30 minutes; hazard ratio, 0.76; confidence interval, 0.63-0.90 [P=0.002]) were significantly associated with lower cardiovascular event rates. Conclusions--Objective measurements of physical activity via accelerometry were associated with cardiovascular events among older adults with limited mobility (summary score > 10 on the Short Physical Performance Battery) both using baseline and longitudinal data. © 2017 The Authors.
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Objective: The objective of this study was to evaluate cross-sectional and longitudinal associations between ankle-brachial index (ABI) and indicators of cognitive function. Design: Randomized clinical trial (Lifestyle Interventions and Independence for Elders Trial). Setting: Eight US academic centers. Participants: A total of 1601 adults ages 70-89 years, sedentary, without dementia, and with functional limitations. Measurements: Baseline ABI and interviewer- and computer-administered cognitive function assessments were obtained. These assessments were used to compare a physical activity intervention with a health education control. Cognitive function was reassessed 24 months later (interviewer-administered) and 18 or 30 months later (computer-administered) and central adjudication was used to classify individuals as having mild cognitive impairment, probable dementia, or neither. Results: Lower ABI had a modest independent association with poorer cognitive functioning at baseline (partial r= 0.09; P < .001). Although lower baseline ABI was not associated with overall changes in cognitive function test scores, it was associated with higher odds for 2-year progression to a composite of either mild cognitive impairment or probable dementia (odds ratio 2.60 per unit lower ABI; 95% confidence interval 1.06-6.37). Across 2 years, changes in ABI were not associated with changes in cognitive function. Conclusion: In an older cohort sedentary individuals with dementia and with functional limitations, lower baseline ABI was independently correlated with cognitive function and associated with greater 2-year risk for progression to mild cognitive impairment or probable dementia. © 2015 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
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