Purpose. This cross-sectional study investigates deficits and associations in muscle strength, 6-minute walking distance (6MWD), aerobic capacity (VO2peak), and physical activity (PA) in independent ambulatory children with lumbosacral spina bifida. Method. Twenty-tree children participated (13 boys, 10 girls). Mean age (SD): 10.4 (±3.1) years. Muscle strength (manual muscle testing and hand-held dynamometry), 6MWD, VO2peak (maximal exercise test on a treadmill), and PA (quantity and energy expenditure [EE]), were measured and compared with aged-matched reference values. Results. Strength of upper and lower extremity muscles, and VO2peak were significantly lower compared to reference values. Mean Z-scores ranged from -1.2 to -2.9 for muscle strength, and from -1.7 to -4.1 for VO2peak. EE ranged from 73 - 84% of predicted EE. 6MWD was significantly associated with muscle strength of hip abductors and foot dorsal flexors. VO2peak was significantly associated with strength of hip flexors, hip abductors, knee extensors, foot dorsal flexors, and calf muscles. Conclusions. These children have significantly reduced muscle strength, 6MWD, VO2peak and lower levels of PA, compared to reference values. VO2peak and 6MWD were significantly associated with muscle strength, especially with hip abductor and ankle muscles. Therefore, even in independent ambulating children training on endurance and muscle strength seems indicated.
Purpose. This cross-sectional study investigates deficits and associations in muscle strength, 6-minute walking distance (6MWD), aerobic capacity (VO2peak), and physical activity (PA) in independent ambulatory children with lumbosacral spina bifida. Method. Twenty-tree children participated (13 boys, 10 girls). Mean age (SD): 10.4 (±3.1) years. Muscle strength (manual muscle testing and hand-held dynamometry), 6MWD, VO2peak (maximal exercise test on a treadmill), and PA (quantity and energy expenditure [EE]), were measured and compared with aged-matched reference values. Results. Strength of upper and lower extremity muscles, and VO2peak were significantly lower compared to reference values. Mean Z-scores ranged from -1.2 to -2.9 for muscle strength, and from -1.7 to -4.1 for VO2peak. EE ranged from 73 - 84% of predicted EE. 6MWD was significantly associated with muscle strength of hip abductors and foot dorsal flexors. VO2peak was significantly associated with strength of hip flexors, hip abductors, knee extensors, foot dorsal flexors, and calf muscles. Conclusions. These children have significantly reduced muscle strength, 6MWD, VO2peak and lower levels of PA, compared to reference values. VO2peak and 6MWD were significantly associated with muscle strength, especially with hip abductor and ankle muscles. Therefore, even in independent ambulating children training on endurance and muscle strength seems indicated.
Abstract Background: 30 to 60% of the acute hospitalized older adults experience functional decline after hospitalization. The first signs of functional decline after discharge can often be observed in the inability to perform mobility tasks, such as raising from a chair or walking. Information how mobility develops over time is scarce. Insight in the course of mobility is needed to prevent and decrease mobility limitations. Objectives: The objectives of this study were to determine (i) the course of mobility of acute hospitalized older adults and (ii) the association between muscle strength and the course of mobility over time controlled for influencing factors. Methods: In a multicenter, prospective, observational cohort study, measurements were taken at admission, discharge, one- and three months post-discharge. Mobility was assessed by the De Morton Mobility Index (DEMMI) and muscle strength by the JAMAR. The longitudinal association between muscle strength and mobility was analysed with a Linear Mixed Model and controlled for potential confounders. Results: 391 older adults were included in the analytic sample with a mean (SD) age of 79.6 (6.7) years. Mobility improved significantly from admission up to three months post-discharge but did not reach normative levels. Muscle strength was associated with the course of mobility (beta=0.64; p<0.01), even after controlling for factors as age, cognitive impairment, fear of falling and depressive symptoms (beta=0.35; p<0.01). Conclusion: Muscle strength is longitudinally associated with mobility. Interventions to improve mobility including muscle strength are warranted, in acute hospitalized older adults.
