TY - JOUR A1 - Baritello, Omar A1 - Salzwedel, Annett A1 - Sündermann, Simon A1 - Niebauer, Josef A1 - Völler, Heinz T1 - The Pandora's Box of frailty assessments: Which is the best for clinical purposes in TAVI patients? A critical review JF - Journal of Clinical Medicine N2 - Frailty assessment is recommended before elective transcatheter aortic valve implantation (TAVI) to determine post-interventional prognosis. Several studies have investigated frailty in TAVI-patients using numerous assessments; however, it remains unclear which is the most appropriate tool for clinical practice. Therefore, we evaluate which frailty assessment is mainly used and meaningful for ≤30-day and ≥1-year prognosis in TAVI patients. Randomized controlled or observational studies (prospective/retrospective) investigating all-cause mortality in older (≥70 years) TAVI patients were identified (PubMed; May 2020). In total, 79 studies investigating frailty with 49 different assessments were included. As single markers of frailty, mostly gait speed (23 studies) and serum albumin (16 studies) were used. Higher risk of 1-year mortality was predicted by slower gait speed (highest Hazard Ratios (HR): 14.71; 95% confidence interval (CI) 6.50–33.30) and lower serum albumin level (highest HR: 3.12; 95% CI 1.80–5.42). Composite indices (five items; seven studies) were associated with 30-day (highest Odds Ratio (OR): 15.30; 95% CI 2.71–86.10) and 1-year mortality (highest OR: 2.75; 95% CI 1.55–4.87). In conclusion, single markers of frailty, in particular gait speed, were widely used to predict 1-year mortality. Composite indices were appropriate, as well as a comprehensive assessment of frailty. View Full-Text KW - frailty tool KW - TAVI KW - older patients KW - elderly KW - cardiology KW - mortality Y1 - 2021 U6 - https://doi.org/10.3390/jcm10194506 SN - 2077-0383 VL - 10 SP - 1 EP - 17 PB - MDPI CY - Basel, Schweiz ET - 19 ER - TY - GEN A1 - Baritello, Omar A1 - Salzwedel, Annett A1 - Sündermann, Simon A1 - Niebauer, Josef A1 - Völler, Heinz T1 - The Pandora's Box of frailty assessments: Which is the best for clinical purposes in TAVI patients? A critical review T2 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe N2 - Frailty assessment is recommended before elective transcatheter aortic valve implantation (TAVI) to determine post-interventional prognosis. Several studies have investigated frailty in TAVI-patients using numerous assessments; however, it remains unclear which is the most appropriate tool for clinical practice. Therefore, we evaluate which frailty assessment is mainly used and meaningful for ≤30-day and ≥1-year prognosis in TAVI patients. Randomized controlled or observational studies (prospective/retrospective) investigating all-cause mortality in older (≥70 years) TAVI patients were identified (PubMed; May 2020). In total, 79 studies investigating frailty with 49 different assessments were included. As single markers of frailty, mostly gait speed (23 studies) and serum albumin (16 studies) were used. Higher risk of 1-year mortality was predicted by slower gait speed (highest Hazard Ratios (HR): 14.71; 95% confidence interval (CI) 6.50–33.30) and lower serum albumin level (highest HR: 3.12; 95% CI 1.80–5.42). Composite indices (five items; seven studies) were associated with 30-day (highest Odds Ratio (OR): 15.30; 95% CI 2.71–86.10) and 1-year mortality (highest OR: 2.75; 95% CI 1.55–4.87). In conclusion, single markers of frailty, in particular gait speed, were widely used to predict 1-year mortality. Composite indices were appropriate, as well as a comprehensive assessment of frailty. View Full-Text T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 765 KW - frailty tool KW - TAVI KW - older patients KW - elderly KW - cardiology KW - mortality Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-550440 SN - 1866-8364 VL - 10 SP - 1 EP - 17 PB - Universitätsverlag Potsdam CY - Potsdam ET - 19 ER - TY - JOUR A1 - Vigorito, Carlo A1 - Abreu, Ana A1 - Ambrosetti, Marco A1 - Belardinelli, Romualdo A1 - Corra, Ugo A1 - Cupples, Margaret A1 - Davos, Constantinos H. A1 - Hoefer, Stefan A1 - Iliou, Marie-Christine A1 - Schmid, Jean-Paul A1 - Völler, Heinz A1 - Doherty, Patrick T1 - Frailty and cardiac rehabilitation: A call to action from the EAPC Cardiac Rehabilitation Section JF - European journal of preventive cardiology : the official ESC journal for primary & secondary cardiovascular prevention, rehabilitation and sports cardiology N2 - Frailty is a geriatric syndrome characterised by a vulnerability status associated with declining function of multiple physiological systems and loss of physiological reserves. Two main models of frailty have been advanced: the phenotypic model (primary frailty) or deficits accumulation model (secondary frailty), and different instruments have been proposed and validated to measure frailty. However measured, frailty correlates to medical outcomes in the elderly, and has been shown to have prognostic value for patients in different clinical settings, such as in patients with coronary artery disease, after cardiac surgery or transvalvular aortic valve replacement, in patients with chronic heart failure or after left ventricular assist device implantation. The prevalence, clinical and prognostic relevance of frailty in a cardiac rehabilitation setting has not yet been well characterised, despite the increasing frequency of elderly patients in cardiac rehabilitation, where frailty is likely to influence the onset, type and intensity of the exercise training programme and the design of tailored rehabilitative interventions for these patients. Therefore, we need to start looking for frailty in elderly patients entering cardiac rehabilitation programmes and become more familiar with some of the tools to recognise and evaluate the severity of this condition. Furthermore, we need to better understand whether exercise-based cardiac rehabilitation may change the course and the prognosis of frailty in cardiovascular patients. KW - Frailty KW - cardiac rehabilitation KW - elderly Y1 - 2017 U6 - https://doi.org/10.1177/2047487316682579 SN - 2047-4873 SN - 2047-4881 VL - 24 SP - 577 EP - 590 PB - Sage Publ. CY - London ER - TY - GEN A1 - Vigorito, Carlo A1 - Abreu, Ana A1 - Ambrosetti, Marco A1 - Belardinelli, Romualdo A1 - Corrà, Ugo A1 - Cupples, Margaret A1 - Davos, Constantinos H. A1 - Hoefer, Stefan A1 - Iliou, Marie-Christine A1 - Schmid, Jean-Paul A1 - Völler, Heinz A1 - Doherty, Patrick T1 - Frailty and cardiac rehabilitation BT - a call to action from the EAPC Cardiac Rehabilitation Section T2 - Postprints der Universität Potsdam : Humanwissenschaftliche Reihe N2 - Frailty is a geriatric syndrome characterised by a vulnerability status associated with declining function of multiple physiological systems and loss of physiological reserves. Two main models of frailty have been advanced: the phenotypic model (primary frailty) or deficits accumulation model (secondary frailty), and different instruments have been proposed and validated to measure frailty. However measured, frailty correlates to medical outcomes in the elderly, and has been shown to have prognostic value for patients in different clinical settings, such as in patients with coronary artery disease, after cardiac surgery or transvalvular aortic valve replacement, in patients with chronic heart failure or after left ventricular assist device implantation. The prevalence, clinical and prognostic relevance of frailty in a cardiac rehabilitation setting has not yet been well characterised, despite the increasing frequency of elderly patients in cardiac rehabilitation, where frailty is likely to influence the onset, type and intensity of the exercise training programme and the design of tailored rehabilitative interventions for these patients. Therefore, we need to start looking for frailty in elderly patients entering cardiac rehabilitation programmes and become more familiar with some of the tools to recognise and evaluate the severity of this condition. Furthermore, we need to better understand whether exercise-based cardiac rehabilitation may change the course and the prognosis of frailty in cardiovascular patients. T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 406 KW - frailty KW - cardiac rehabilitation KW - elderly Y1 - 2018 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-405172 IS - 406 ER - TY - GEN A1 - Granacher, Urs A1 - Lacroix, Andre A1 - Mühlbauer, Thomas A1 - Roettger, Katrin A1 - Gollhofer, Albert T1 - Effects of core instability strength training on trunk muscle strength, spinal mobility, dynamic balance and functional mobility in older adults N2 - Background: Age-related postural misalignment, balance deficits and strength/power losses are associated with impaired functional mobility and an increased risk of falling in seniors. Core instability strength training (CIT) involves exercises that are challenging for both trunk muscles and postural control and may thus have the potential to induce benefits in trunk muscle strength, spinal mobility and balance performance. Objective: The objective was to investigate the effects of CIT on measures of trunk muscle strength, spinal mobility, dynamic balance and functional mobility in seniors. Methods: Thirty-two older adults were randomly assigned to an intervention group (INT; n = 16, aged 70.8 +/- 4.1 years) that conducted a 9-week progressive CIT or to a control group (n = 16, aged 70.2 +/- 4.5 years). Maximal isometric strength of the trunk flexors/extensors/lateral flexors (right, left)/rotators (right, left) as well as of spinal mobility in the sagittal and the coronal plane was measured before and after the intervention program. Dynamic balance (i.e. walking 10 m on an optoelectric walkway, the Functional Reach test) and functional mobility (Timed Up and Go test) were additionally tested. Results: Program compliance was excellent with participants of the INT group completing 92% of the training sessions. Significant group x test interactions were found for the maximal isometric strength of the trunk flexors (34%, p < 0.001), extensors (21%, p < 0.001), lateral flexors (right: 48%, p < 0.001; left: 53%, p < 0.001) and left rotators (42%, p < 0.001) in favor of the INT group. Further, training-related improvements were found for spinal mobility in the sagittal (11%, p < 0.001) and coronal plane (11%, p = 0.06) directions, for stride velocity (9%, p < 0.05), the coefficient of variation in stride velocity (31%, p < 0.05), the Functional Reach test (20%, p < 0.05) and the Timed Up and Go test (4%, p < 0.05) in favor of the INT group. Conclusion: CIT proved to be a feasible exercise program for seniors with a high adherence rate. Age-related deficits in measures of trunk muscle strength, spinal mobility, dynamic balance and functional mobility can be mitigated by CIT. This training regimen could be used as an adjunct or even alternative to traditional balance and/or resistance training. T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 332 KW - elderly KW - gait KW - muscle strength KW - physical performance KW - postural balance Y1 - 2017 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-399994 ER - TY - GEN A1 - Granacher, Urs A1 - Mühlbauer, Thomas A1 - Bridenbaugh, Stephanie A. A1 - Wolf, Madeleine A1 - Roth, Ralf A1 - Gschwind, Yves A1 - Wolf, Irene A1 - Mata, Rui A1 - Kressig, Reto W. T1 - Effects of a salsa dance training on balance and strength performance in older adults N2 - Background: Deficits in static and particularly dynamic postural control and force production have frequently been associated with an increased risk of falling in older adults. Objective: The objectives of this study were to investigate the effects of salsa dancing on measures of static/dynamic postural control and leg extensor power in seniors. Methods: Twenty-eight healthy older adults were randomly assigned to an intervention group (INT, n = 14, age 71.6 +/- 5.3 years) to conduct an 8-week progressive salsa dancing programme or a control group (CON, n = 14, age 68.9 +/- 4.7 years). Static postural control was measured during one-legged stance on a balance platform and dynamic postural control was obtained while walking on an instrumented walkway. Leg extensor power was assessed during a countermovement jump on a force plate. Results: Programme compliance was excellent with participants of the INT group completing 92.5% of the dancing sessions. A tendency towards an improvement in the selected measures of static postural control was observed in the INT group as compared to the CON group. Significant group X test interactions were found for stride velocity, length and time. Post hoc analyses revealed significant increases in stride velocity and length, and concomitant decreases in stride time. However, salsa dancing did not have significant effects on various measures of gait variability and leg extensor power. Conclusion: Salsa proved to be a safe and feasible exercise programme for older adults accompanied with a high adherence rate. Age-related deficits in measures of static and particularly dynamic postural control can be mitigated by salsa dancing in older adults. High physical activity and fitness/mobility levels of our participants could be responsible for the nonsignificant findings in gait variability and leg extensor power. T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 330 KW - elderly KW - postural sway KW - gait KW - force production Y1 - 2017 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-399962 ER - TY - THES A1 - Lacroix, André T1 - Factors influencing the effectiveness of balance and resistance training in older adults T1 - Effektivität von Gleichgewichts- und Krafttraining bei älteren Menschen: beeinflussende Faktoren N2 - Hintergrund und Ziele: Altersbedingte Kraft- und Gleichgewichtsverluste sind mit Funktionseinschränkungen und einem erhöhten Sturzrisiko assoziiert. Kraft- und Gleichgewichtstraining haben das Potenzial, das Gleichgewicht und die Maximalkraft/Schnellkraft von gesunden älteren Menschen zu verbessern. Es ist jedoch noch nicht hinreichend untersucht, wie die Effektivität solcher Übungsprogramme von verschiedenen Faktoren beeinflusst wird. Hierzu gehören die Rolle der Rumpfmuskulatur, die Effekte von kombiniertem Kraft- und Gleichgewichtstraining sowie die Effekte der Trainingsanleitung. Die primären Ziele dieser Dissertation bestehen daher in der Überprüfung der Zusammenhänge von Rumpfkraft und Gleichgewichtsvariablen und der Effekte von kombiniertem Kraft- und Gleichgewichtstraining auf ein breites Spektrum an intrinsischen Sturzrisikofaktoren bei älteren Menschen. Ein wesentliches Ziel dieser Dissertation ist zudem die Überprüfung der Auswirkungen von angeleitetem gegenüber unangeleitetem Kraft- und/oder Gleichgewichtstraining auf Variablen des Gleichgewichts und der Maximal-/Schnellkraft bei älteren Menschen. Methoden: Gesunde ältere Erwachsene im Alter zwischen 63 und 80 Jahren wurden in einer Querschnittsstudie, einer Längsschnittstudie und einer Metaanalyse untersucht (Gruppenmittelwerte Meta-Analyse: 65.3-81.1 Jahre). Messungen des Gleichgewichts (statisches/dynamisches, proaktives, reaktives Gleichgewicht) wurden mittels klinischer (z. B. Romberg Test) und instrumentierter Tests (z. B. 10 Meter Gangtest inklusive elektrischer Erfassung von Gangparametern) durchgeführt. Die isometrische Maximalkraft der Rumpfmuskulatur wurde mit speziellen Rumpfkraft-Maschinen gemessen. Für die Überprüfung der dynamischen Maximal-/Schnellkraft der unteren Extremität wurden klinische Tests (z. B. Chair Stand Test) verwendet. Weiterhin wurde ein kombiniertes Kraft- und Gleichgewichtstraining durchgeführt, um trainingsbedingte Effekte auf Gleichgewicht und Maximal-/Schnellkraft sowie die Effekte der Trainingsanleitung bei älteren Erwachsenen zu untersuchen. Ergebnisse: Die Ergebnisse zeigten signifikante Korrelationen zwischen Rumpfkraft und statischem sowie ausgewählten Parametern des dynamischen Gleichgewichts (0.42 ≤ r ≤ 0.57). Kombiniertes Kraft- und Gleichgewichtstraining verbesserte das statische/dynamische (z. B. Romberg Test, Ganggeschwindigkeit), proaktive (z. B. Timed Up und Go Test) und reaktive Gleichgewicht (z. B. Push and Release Test) sowie die Maximal-/Schnellkraft (z. B. Chair Stand Test) von gesunden älteren Menschen (0.62 ≤ Cohen’s d ≤ 2.86; alle p < 0.05). Angeleitetes Training führte verglichen mit unangeleitetem Training zu größeren Effekten bei Gleichgewicht und Maximal-/Schnellkraft [Längsschnittstudie: Effekte in der angeleiteten Gruppe 0.26 ≤ d ≤ 2.86, Effekte in der unangeleiteten Gruppe 0.06 ≤ d ≤ 2.30; Metaanalyse: alle Standardisierte Mittelwertdifferenzen (SMDbs) zugunsten der angeleiteten Programme 0.24-0.53]. Die Metaanalyse zeigte zudem größere Effekte zugunsten der angeleiteten Programme, wenn diese mit komplett unbeaufsichtigten Programmen verglichen wurden (0.28 ≤ SMDbs ≤ 1.24). Diese Effekte zugunsten der angeleiteten Interventionen wurden jedoch abgeschwächt, wenn sie mit unangeleiteten Interventionen verglichen wurden, die wenige zusätzliche angeleitete Einheiten integrierten (−0.06 ≤ SMDbs ≤ 0.41). Schlussfolgerungen: Eine Aufnahme von Rumpfkraftübungen in sturzpräventive Trainingsprogramme für ältere Menschen könnte die Verbesserung von Gleichgewichtsparametern positiv beeinflussen. Die positiven Effekte auf eine Vielzahl wichtiger intrinsischer Sturzrisikofaktoren (z. B. Gleichgewichts-, Kraftdefizite) implizieren, dass besonders die Kombination aus Kraft- und Gleichgewichtstraining eine durchführbare und effektive sturzpräventive Intervention ist. Aufgrund größerer Effekte von angeleitetem im Vergleich zu unangeleitetem Training sollten angeleitete Einheiten in sturzpräventive Übungsprogramme für ältere Erwachsene integriert werden. N2 - Background and objectives: Age-related losses of lower extremity muscle strength/power and deficits in static and particularly dynamic balance are associated with impaired functional performance and the occurrence of falls. It has been shown that balance and resistance training have the potential to improve balance and muscle strength in healthy older adults. However, it is still open to debate how the effectiveness of balance and resistance training in older adults is influenced by different factors. This includes the role of trunk muscle strength, the comprehensive effects of combined balance and resistance training, and the role of exercise supervision. Therefore, the primary objectives of this doctoral thesis are to investigate the relationship between trunk muscle strength and balance performance and to examine the effects of an expert-based balance and resistance training protocol on various measures of balance and lower extremity muscle strength/power in older adults. Furthermore, the impact of supervised versus unsupervised balance and/or resistance training interventions in the elderly will be evaluated. Methods: Healthy older adults aged 63-80 years were included in a cross-sectional study, a longitudinal study, and a meta-analysis (range group means meta-analysis: 65.3-81.1 years) registering balance and muscle strength/power performance. Different measures of balance (i.e., static/dynamic, proactive, reactive) were examined using clinical (e.g., Romberg test) and instrumented tests (e.g., 10 meter walking test on a sensor-equipped walkway). Isometric strength of the trunk muscles was assessed using instrumented trunk muscle strength apparatus and lower extremity dynamic muscle strength/power was examined using clinical tests (e.g., Chair Stand Test). Further, a combined balance and resistance training protocol was applied to examine training-induced effects on balance and muscle strength/power as well as the role of supervision in older adults. Results: Findings revealed that measures of trunk muscle strength and static steady-state balance as well as specific measures of dynamic steady-state balance were significantly associated in the elderly (0.42 ≤ r ≤ 0.57). Combined balance and resistance training significantly improved older adults' static/dynamic steady-state (e.g., Romberg test; habitual gait speed), pro-active (e.g., Timed Up and Go Test), and reactive balance (e.g., Push and Release Test) as well as muscle strength/power (e.g., Chair Stand Test) (0.62 ≤ Cohen’s d ≤ 2.86; all p < 0.05). Supervised compared to unsupervised balance and/or resistance training was superior in enhancing older adults' balance and muscle strength/power performance regarding all observed outcome categories [longitudinal study: effects for the supervised group 0.26 ≤ d ≤ 2.86, effects for the unsupervised group 0.06 ≤ d ≤ 2.30; meta-analysis: all between-subject standardized mean differences (SMDbs) in favor of the supervised training programs 0.24-0.53]. The meta-analysis additionally showed larger effects in favor of supervised interventions when compared to completely unsupervised interventions (0.28 ≤ SMDbs ≤ 1.24). These effects in favor of the supervised programs faded when compared with studies that implemented a small amount of supervised sessions in their unsupervised interventions (−0.06 ≤ SMDbs ≤ 0.41). Conclusions: Trunk muscle strength is associated with steady-state balance performance and may therefore be integrated in fall-preventive exercise interventions for older adults. The examined positive effects on a large number of important intrinsic fall risk factors (e.g., balance deficits, muscle weakness) imply that particularly the combination of balance and resistance training appears to be a feasible and effective exercise intervention for fall prevention. Owing to the beneficial effects of supervised compared to unsupervised interventions, supervised sessions should be integrated in fall-preventive balance and/or resistance training programs for older adults. KW - Senioren KW - Gleichgewicht KW - Maximalkraft/Schnellkraft KW - Rumpfkraft KW - Gleichgewichtstraining KW - Krafttraining KW - Übungsanleitung KW - elderly KW - balance KW - lower extremity muscle strength/power KW - trunk muscle strength KW - balance training KW - resistance training KW - exercise supervision Y1 - 2017 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-411826 ER - TY - JOUR A1 - Granacher, Urs A1 - Lacroix, Andre A1 - Roettger, Katrin A1 - Gollhofer, Albert A1 - Mühlbauer, Thomas T1 - Relationships between trunk muscle strength, spinal mobility, and balance performance in older adults JF - Journal of aging and physical activity N2 - This study investigated associations between variables of trunk muscle strength (TMS), spinal mobility, and balance in seniors. Thirty-four seniors (sex: 18 female, 16 male; age: 70 +/- 4 years; activity level: 13 +/- 7 hr/week) were tested for maximal isometric strength (MIS) of the trunk extensors, flexors, lateral flexors, rotators, spinal mobility, and steady-state, reactive, and proactive balance. Significant correlations were detected between all measures of TMS and static steady-state balance (r = .43.57, p < .05). Significant correlations were observed between specific measures of TMS and dynamic steady-state balance (r = .42.55, p < .05). No significant correlations were found between all variables of TMS and reactive/proactive balance and between all variables of spinal mobility and balance. Regression analyses revealed that TMS explains between 1-33% of total variance of the respective balance parameters. Findings indicate that TMS is related to measures of steady-state balance which may imply that TMS promoting exercises should be integrated in strength training for seniors. KW - elderly KW - core KW - gait KW - postural balance KW - force KW - physical performance Y1 - 2014 U6 - https://doi.org/10.1123/JAPA.2013-0108 SN - 1063-8652 SN - 1543-267X VL - 22 IS - 4 SP - 490 EP - 498 PB - Human Kinetics Publ. CY - Champaign ER - TY - JOUR A1 - Voigt, Andrea A1 - Scheffler, Christiane T1 - Manual abilities of the elderly - handgrip strength, finger and thumb push strength and opening strength in age comparison JF - Journal of biological and clinical anthropology : Anthropologischer Anzeiger ; Mitteilungsorgan der Gesellschaft für Anthropologie N2 - The purpose of this paper is to display the static strength capacities of healthy adults in different age categories. A total of 279 healthy German adults at the ages of 20 to 29 years, 50 to 59 years and 60 to 69 years generated their maximum static handgrip, index finger and thumb push strength, as well as their maximum opening strength on a smooth jar lid of 85 mm diameter and on a knurled bottle lid of 31 mm with their right hand. The results show larger male strength than female strength. Significant age-induced differences appear primarily in opening strengths between the age groups 20 to 29 and 50 to 59 years in male subjects and in female opening strengths between the age groups 20 to 29 and 60 to 69 years as well as between the age groups 50 to 59 and 60 to 69 years. Of greatest interest is that elderly men show the largest opening strengths. KW - elderly KW - torque KW - handgrip strength KW - opening strength Y1 - 2011 U6 - https://doi.org/10.1127/0003-5548/2011/0090 SN - 0003-5548 VL - 68 IS - 2 SP - 167 EP - 173 PB - Schweizerbart CY - Stuttgart ER -