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- Åberg, Anna Cristina, et al.
(författare)
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Medio-lateral stability of sit-to-walk performance in older individuals with and without fear of falling
- 2010
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Ingår i: Gait & Posture. - : Elsevier BV. - 0966-6362 .- 1879-2219. ; 31:4, s. 438-443
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Tidskriftsartikel (refereegranskat)abstract
- Most falls in older people are due to loss of balance during everyday locomotion, e.g., when initiating walking from sitting; sit-to-walk (STW). It has been considered that the broader stride width in walking that is seen in many people with fear of falling (FoF) does not increase stability, but could be predictive of future falls because of increased medio-lateral (ML) velocity of the body centre of mass (CoM). This study was aimed to examine step-, velocity- and stability-related parameters, focusing on ML stability, in STW performance of people with and without FoF. Ten subjects with FoF and 10 matched controls, aged >= 70 years, were included. Kinematic and kinetic data were collected in a laboratory. Stability parameters were calculated from a formula implying that the vertical projection of the CoM extrapolated by adding its velocity times a factor root l/g (height of inverted pendulum divided by gravity) should fall within the base of support (BoS). A related spatial margin of stability (SMoS), defined as the minimum distance from the extrapolated CoM (XCoM) to the boundaries of the BoS, was also calculated. In the phase 'seat-off-second-toe-off, the FoF group had significantly (p < 0.05) shorter and broader steps, lower forward but similar ML CoM velocity, and broader CoM and XCoM widths. The FoF group therefore exhibited a disproportionately large sideways velocity compared to the controls. This indicates that STW may be a hazardous transfer for older people with FoF, which should be relevant in assessment and training aimed at preventing falls.
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| 2. |
- Nerpin, Elisabet, et al.
(författare)
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The association between glomerular filtration rate and left ventricular function in two independent community-based cohorts of elderly
- 2014
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Ingår i: Nephrology, Dialysis and Transplantation. - : Oxford University Press (OUP). - 0931-0509 .- 1460-2385. ; 29:11, s. 2069-2074
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Tidskriftsartikel (refereegranskat)abstract
- The cardiorenal syndrome, the detrimental bi-directional interplay between symptomatic heart failure and chronic kidney disease, is a major clinical challenge. Nonetheless, it is unknown if this interplay begins already at an asymptomatic stage. Therefore we investigated whether the glomerular filtration rate (GFR) is associated with left ventricular function in participants free from clinical heart failure and with a left ventricular ejection fraction (LVEF) > 40% and with pre-specified sub-group analyses in individuals with a GFR > 60 mL/min/m(2). Two independent community-based cohorts were used; the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS; n = 911; 50% women; mean age: 70 years) and the Uppsala Longitudinal Study of Adult Men (ULSAM; n = 538; mean age: 71 years). We investigated cross-sectional association between cystatin C-based GFR (estimated glomerular function [eGFR]) and systolic (LVEF), diastolic- (isovolumic relaxation time [IVRT]) and global left ventricular function (myocardial performance index [MPI]) determined by echocardiography. In both PIVUS and ULSAM, higher eGFR was significantly associated with higher LVEF (P = 0.004 [PIVUS] and P = 0.005 [ULSAM]). In PIVUS, higher eGFR was significantly associated with lower IVRT (P = 0.001) and MPI (P = 0.006), in age- and sex-adjusted models. After further adjustment for cardiovascular risk factors, the association between higher eGFR and higher LVEF was still statistically significant (P = 0.008 [PIVUS] and P = 0.02 [ULSAM]). In PIVUS, the age- and sex-adjusted association between eGFR and left ventricular function was similar in participants with eGFR > 60 mL/min/m(2). Our data suggest that the interplay between kidney and heart function begins prior to the development of symptomatic heart failure and kidney disease.
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