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- Assessing physical activity and functional fitness level using convolutional neural networksPublication . Galán-Mercant, Alejandro; Ortiz, Andrés; Herrera-Viedma, Enrique; Tomás, Maria Teresa; Fernandes, Beatriz; Moral-Munoz, Jose A.Older adults are related to a reduction in physical functionality, as a result of a musculoskeletal system degeneration. In that way, physical exercise has been stated as a suitable intervention to prevent such health problems. Therefore, an adequate assessment of the physical activity and functional fitness levels is needed to plan the individualized intervention. A broad test used to assess the functional fitness level is the 6-minutes walk test (6MWT). It has been previously measured using accelerometer sensors. In views of this background, the main aim of the present study is to use deep learning to extract automatically and to predict the physical activity and functional fitness levels of the older adults through the acceleration signals recorded by a smartphone during the 6MWT. A total of 17 participants were recruited. Anthropometric measurements (weight, height, and body mass index), physical activity, and functional fitness levels from each participant were recorded. Consecutively, two deep learning-based methods were applied to determine the prediction. According to the results, the proposed method can predict physical activity and functional fitness levels with high accuracy, even using only one cycle. Thus, the approach described in the present work could be implemented in future mobile health systems to identify the physical activity profile of older adults.
- Functional capacity and levels of physical activity in aging: a 3-year follow-upPublication . Tomás, Maria Teresa; Galán-Mercant, Alejandro; Alvarez Carnero, Elvis; Fernandes, BeatrizOver the last decades, the world elderly population has increased exponentially and this tendency will continue during the coming years; from 2000 to 2050, people over 60 will double and those over 80 will quadruple. Loss of independence occurs as people age due to mobility restrictions, frailty, and decreased functional fitness and cognitive abilities. Evidence has shown that appropriate programs and policies contribute to keep older adults healthy and independent over time. The purpose of this chapter is to report the results of our 3-year follow-up study designed to characterize functional physical fitness in a sample of Portuguese community-dwelling older adults to propose a set of functional parameters that decline the most. We studied a group of 43 elderly people, aged 60 and over. Variables assessed on the participants were anthropometric measurements, functional capacity with the Senior Fitness Test battery (muscle strength, aerobic endurance, flexibility, agility, and dynamic balance), handgrip strength, levels of physical activity, and balance. Three years after the first assessment, a second assessment of the same variables was conducted. We analyzed what were the variables that, for this group, were related to a healthier aging and the relation with different physical activity levels. Our study showed that the distance covered in 6-min walk test and handgrip strength seem to explain a great amount of variability on functional variables that have changed on this period (68% of balance, lower and upper functional strength, respectively) and the active participants showed fewer decrements with aging in anthropometric and functional variables than those inactive or insufficiently active (p < 0.05). Greater importance should be given to prescription of exercise targeting older adults and, specifically, walking and manual activities should be given more attention as components of a community exercise program.
- Body composition changes over three years in older adults: a descriptive longitudinal analysisPublication . Tomás, Maria Teresa; Galán-Mercant, Alejandro; Fernandes, BeatrizIntroduction: Many studies analyze body composition changes in older adults. However, few studies analyze body composition in elderly people with functional measures. Studies using Double X-Ray analysis (DXA) or Bioimpedance analysis proved to be reliable but expensive or only possible in a laboratory environment. The purpose of our study was to analyze changes in body composition over three years using anthropometric measures in a sample of elderly people in order to perceive functional changes. Methods: Forty-three participants (12 men; 31 women) aged 60 years and over and independent in activities of daily life were assessed using anthropometric measures in the first moment and past three years. Weight, height, waist and hip circumference were measured, and body mass index (BMI) and waist-to-hip ratio (WHR) were also calculated. Skeletal muscle mass (SMM) was also calculated using Al-Gindan et al. (2014) equations and normalized for height to found skeletal muscle index (SMI) in order to analyze cut-off points associated with physical disability according to Janssen et al (2004). Results: A significant difference was found over three years in SMM (p = 0.007), SMI (p = 0.027), BMI (p = 0.041) and WHR (p = 0.003). The majority of the participants has decreased SMM, SMI, and BMI and increased WHR, which favors a worst prognostic for comorbidities associated with these variables, and a tendency for sarcopenic obesity seems to be present although more studies are needed. Also, we found that using cut-off points for disability risk 83.3% of the men and 38.7% of the women of our sample were at moderate or high risk of disability. Three years later this percentage has increased but only for women to 54.8%. Conclusions: Although men are at risk of disability, women quickly lose their functional capacity, making necessary a rapid intervention to reduce the risk of disability in this population.
- Instrumented 6-minutes walk test, an approach to improve the traditional testPublication . Galán-Mercant, Alejandro; Tomás, Maria Teresa; Fernandes, BeatrizIntroduction: Exercise testing is frequently used to assist clinicians in assessing prognosis and evaluating response to treatment. The 6-min walk test is a standardized test of functional exercise capacity. Objectives: The aim of the present study was to identify and describe the anthropometric characteristics, gait velocity and instrumented 6-min walk test with kinematics parameters from the inertial sensor during the test in a Portuguese population of subjects over 65 years. Methods: They were measured variables related to anthropometrics, the 6-min walk test and kinematic variables in the 6-min walk test related to accelerations and angular velocity. Results: The results were; six minutes walk (359,26 ± 107.49 meters), initial heart rate (72,95 ± 7,74BPM), final initial heart rate (80,58 ± 13,86 BPM), initial systolic blood pressure (148,42 ± 21,25 mmHg), final systolic blood pressure (164,26 ± 24,49 mmHg), initial diastolic blood pressure (75,63 ± 11,04 mmHg), final diastolic blood pressure (77,00 ± 9,52 mmHg), gait velocity (1,04 ± 0,37 m/s), max rotation rate X (1,05 ± 0,36 rad/s), min rotation rate X (−0,82 ± 0,33 rad/s), max rotation rate Y (2,63 ± 0,96 rad/s), min rotation rate Y (−1,69 ± 0,81 rad/s), max rotation rate Z (1,03 ± 0,33 rad/s), min rotation rate Z (−1,12 ± 0,38 rad/s), max acceleration X (0,77 ± 0,37 m/s2), min acceleration X (−0,91 ± 0,44 m/s2), max acceleration Y (0,53 ± 0,23 m/s2), min acceleration Y (−1,25 ± 0,70 m/s2), max acceleration Z (0,49 ± 0,14 m/s2), min acceleration Z (−0,96 ± 0,34 m/s2). Conclusions: The only one outcome in 6-min walk the test (total distance in meters), could be complemented with inertial sensor information. This new complement could be interesting in order to understand other dimensions in the 6-min walk or identify changes in function and results in the test after a program to improve physical fitness.
- Functional exercise capacity in a sample of elderly women: a three years follow-upPublication . Tomás, Maria Teresa; Galán-Mercant, Alejandro; Fernandes, BeatrizAged population is increasing and physical activity seems to be an effective action to deal with aging effects and decrements in physical activity (PA). However, the correct intensity of prescribed PA is important. Objectives: To verify the decrements in functional exercise capacity in a sample of an elderly woman, in order to adjust possible changes in intensity demands of physical activity and walking activity. Methods: Six minutes’ walk test (6MWT) in a 20 m distance and levels of physical activity (LPA) were assessed. Results: A sample of 30 females aged 77 ± 9 yrs. (63–94 yrs.) and BMI of 27.7 ± 3.5 kg/m2 were assessed 3 years after a first assessment. At the first moment, distance walked was 391.4 ± 107.2 m (137.5–561.2 m) which corresponded to a percentage of 78.9% ± 16.6% of expected distance for age, height, and weight. LPA showed that 50% of this sample was sedentary and only 16.7% (5 females) were active (more than 3 times a week of moderate-intensity physical activity). A second assessment, results showed an increment in distance walked of 6.6 ± 65.0 m which were not expected (percentage of estimated distance was 82.4% ± 19.3%). Only 5 females decreased distance walked. However, this sample was more active. Only 46.7% were a sedentary and active woman was increased by 26.7% (8 females). This increments of LPA were probably due to counseling in the first moment of assessment. Conclusions: Our results seem to show the capital importance of physical activity and namely the walking activity for counter the effects of aging, namely on functional exercise capacity.
- Gait speed, balance and functional capacity in a sample of community-dwelling older adultsPublication . Galán-Mercant, Alejandro; Tomás, Maria Teresa; Fernandes, BeatrizIntroduction: Falls in older people is an important public health concern since they are responsible for a high number of hospitalizations, health complications, disability, and death. Gait speed has been identified as a predictor of health state in elderly populations and it is related to falls and functional capacity. The aim of this study was to identify the risk of falling in a sample of Portuguese older adults living in the community and to investigate the associations between gait speed, balance, and functionality. Methods: This was a cross-sectional study. Assessment included gait speed (GS) with 4-meter walk test; balance with the Berg Balance Scale (BBS); functional capacity with the Composite Physical Function Scale (CPF). Descriptive and correlational statistics were performed to analyze data. Results: 46 community-dwelling older adults (32 women; 14 men) aged 77 ± 9 years participated in our study. Mean value for GS was 1.17 ± 0.37 m/s which is normal for this population. For BBS and CPF median was 52 and 19, respectively. BBS results revealed a risk of falling off 43% and functional capacity of our participants was at moderate levels. The study of correlations between variables also showed positive associations between GS and BBS (R = 0.631; p = 0.00) and between GS and CPF (R = 0.605; p = 0.00). Conclusions: Positive associations between GS and balance and between GS and functional capacity highlight the role of GS in the assessment of fall risk and functional capacity since it is a simple and easy test to perform.
- Handgrip strength and falls among community-dwelling older adultsPublication . Fernandes, Beatriz; Galán-Mercant, Alejandro; Tomás, Maria TeresaIntroduction: Falls prevention in older adults includes early screening for fall risk; risk factor assessment and specialized intervention. Several variables such as balance, gait speed and mobility have been used to assess the risk of falling. More recently, handgrip strength has also been identified for this purpose. The aim of this study was to investigate the relationship between handgrip strength and balance, gait speed and mobility in community-dwelling older adults. Methods: A sample of 45 community-dwelling older adults (16 M; 30F), aged 76.9 ± 8.6 was enrolled in the study. Inclusion criteria were age 65 and over; ability to walk autonomously (with or without assistive devices) and to understand and perform the tests. Participants were excluded if they had limitations interfering with the performance of tests and medical contraindications for exercise. A balance was assessed with the Berg Balance Scale (BBS), mobility with the 8-foot-up-and-go-test, gait speed with the 4-meter walk test and handgrip strength with the hydraulic dynamometer Jamar®. A Spearman’s correlation was run to investigate whether there were associations between variables. Results: A strong positive correlation was found between handgrip strength and balance (rs = 0.645, p = 0.000) and handgrip strength and gait speed (rs = 0.593, p = 0.000). Results from the 8-foot-up-and-go-test (7.8 ± 3.4 s) did not reveal increased risk of falling; however, there was a strong negative correlation between mobility and balance (rs = 0.758, p = 0.000), gait speed (rs = -0.681, p = 0.000) and handgrip strength (rs = -0.632, p = 0.000). Conclusions: For our participants as handgrip strength increases gait speed and balance also increase. Decreases in balance, gait speed, and handgrip strength are related to mobility decline which is related to an increased risk of falling. Our results point-out handgrip strength as a valuable measure to identify the risk of falling. Further studies with larger samples are needed to confirm these results.