BACKGROUND AND PURPOSE:Osteoporosis increases the risk of fragility fractures, contributes to significant morbidity, and is a psychological challenge-fear of falling (FoF)-which can limit activity and engagement in rehabilitation. These challenges are often overlooked after a fracture, despite their relevance to rehabilitation planning. Understanding these challenges is crucial for health care practitioners, particularly physical and occupational therapists, who are central to fall prevention and post-fracture care. This study explored the perspectives of older adults with osteoporosis who had upper extremity fractures, focusing on their health concerns, the impact of falls and FoF on daily life, and their views on rehabilitation. METHODS:This qualitative study used interpretive description methodology. Thirteen participants (mean age: 67.3 years) were recruited from a hospital in Ontario, Canada. In-depth, semi-structured interviews were conducted and analyzed using inductive coding and constant comparison, with themes emerging from the participant narratives. Interviews continued until thematic saturation was reached. RESULTS:Four overarching themes emerged: (1) The complex interplay of multiple factors is associated with falls, (2) Navigating life after a fall involves both adaptive strategies and maladaptive changes, (3) Implementing comprehensive strategies is crucial for preventing falls and managing FoF, and (4) achieving optimal osteoporosis care remains an ongoing struggle. Participants described limited awareness of osteoporosis as a fall risk factor and gaps in education and rehabilitation support. CONCLUSIONS:Older adults with osteoporosis face multifaceted challenges related to fall risk and FoF. Findings highlight the need for better patient education, psychological support, and access to comprehensive rehabilitation addressing both physical and psychological health needs.
BACKGROUND AND PURPOSE:While sarcopenia and dynapenia, common in older adult, are known to affect general motor function, their specific effects on inspiratory muscle strength and cardiorespiratory fitness have not been adequately investigated. Therefore, the aim of our study was to compare inspiratory muscle strength and cardiovascular fitness levels in sarcopenic, dynapenic, and older adults without sarcopenia or dynapenia. METHODS:The study included 75 community-dwelling older adults aged 65-85. Individuals were divided into 3 groups: dynapenic, sarcopenic, and control groups (older adults without sarcopenia or dynapenia), according to the ISarcoPRM diagnostic algorithm, which includes measuring anterior thigh thickness by ultrasonography. The S-index, flow, and volume parameters were measured using the Powerbreathe K5 system to assess inspiratory muscle strength in older adults. A 2-minute step test (2MST) was used to assess cardiorespiratory fitness. RESULTS:The sarcopenic group had lower values than the control in the S-index, flow, and volume parameters ( p < .05). In the 2MST, which evaluates cardiorespiratory fitness, all three groups were different from each other, and the sarcopenic group had the lowest scores ( p < .05). It was observed that anterior thigh muscle thickness had a low correlation with volume ( r = 0.347, p = .002). Anterior thigh muscle thickness had a moderate correlation with S-index ( r = 0.405, p < .001), flow ( r = 0.421, p < .001), and 2MST ( r = 0.454, p < .001). CONCLUSION:It is thought that loss of respiratory muscle strength in older adults is seen in individuals with loss of muscle mass (sarcopenic).
BACKGROUND AND PURPOSE:Toe pressure strength measured in the standing position has been shown to contribute more to health promotion and disease prevention in older adults than conventional toe grip strength. Toe pressure strength in the standing position was associated with standing ability and walking speed. However, it remains unclear whether interventions designed to improve toe pressure strength in the standing position (ie, assessed while standing) increase muscle strength and improve physical function. This study aimed to examine the effects of interventions on toe pressure strength in the standing position among community-dwelling older adults participating in a day program. METHODS:This double-blind randomized controlled trial was conducted among community-dwelling older adults participating in a day program. The 40 participants selected for analysis were randomly divided into a control group (n = 20) and an intervention group (n = 20). The control group received standard rehabilitation, whereas the intervention group received standard rehabilitation plus toe pressure strength training (5 seconds × 10 repetitions for 3 sets over 12 weeks). Two-way repeated-measures analysis of variance was conducted to compare changes in variables after the intervention between groups. RESULTS AND DISCUSSION:18 participants in each group completed the intervention and were included in the final analysis (control: 82 ± 6 years, 67% female; intervention: 85 ± 5 years, 61% female). A significant interaction was observed between toe pressure strength in the standing position and maximum walking speed. The post hoc tests showed no significant differences in any of the variables at baseline between the groups. Conversely, significant differences only in toe pressure strength in the standing position and maximum walking speed was observed between the groups after 12 weeks. CONCLUSIONS:Toe pressure strength training improved toe pressure strength in the standing position and maximum walking speed. This has been the first study to clarify the effects of toe pressure strength training, with our results highlighting its importance in the community-dwelling older adults.
