Abstract
Background
Many recent guidelines and consensus on sarcopenia have incorporated gait speed and
grip strength as diagnostic criteria without addressing early posture changes adopted
to maintain gait speed before weakness is clinically evident.
Objectives
Older adults are known to compensate well for declining physiological reserve through
environmental modification and posture adaptation. This study aimed to analyze and
identify significant posture adaptation in older adults that is required to maintain
gait speed in the face of increasing vulnerability. This would be a useful guide for
early posture correction exercise interventions to prevent further decline, in addition
to traditional gait, balance, and strength training.
Design
A community-based cross-sectional study.
Setting and Participants
The participants comprised 90 healthy community-dwelling Chinese men between the ages
of 60 and 80 years and 20 Chinese adults between the ages of 21 and 50 years within
the normal BMI range as a comparison group.
Measurements
All the participants underwent handgrip strength testing, 6-minute walk, timed up-and-go
(TUG), and motion analysis for gait characteristics. Low function was characterized
by slow walking speed (<1.0 m/s) and/or slow TUG (>10 seconds), whereas low strength
was determined by hand grip dynamometer testing (<26 kg). The degree of frailty was
classified using the Canadian Study for Health and Ageing Clinical Frailty Scale (CSHA-CFS)
to differentiate between healthy and vulnerable older adults.
Results
As expected, the vulnerable older adults had lower functional performance and strength
compared with the healthy older adults group. However, a significant number demonstrated
posture adaptations in walking in all 3 groups, including those who maintained a good
walking speed (>1.0 m/s). The extent of such adaptation was larger in the vulnerable
group as compared with the healthy group.
Conclusion
Although gait speed is a robust parameter for screening older adults for sarcopenia
and frailty, our data suggest that identifying trunk posture adaptation before the
onset of decline in gait speed will help in planning interventions in the at-risk
community-dwelling older adults even before gait speed declines.
Keywords
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Article info
Publication history
Published online: September 22, 2015
Footnotes
The authors declare no conflicts of interest.
This work was supported by a grant (NRF 2008 NRF-CRP 001–30) from the Competitive Research Program of the National Research Foundation, Singapore.
Identification
Copyright
© 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.
