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- All Subjects: Older people--Orientation and mobility.
- Creators: Dickinson, Jared
- Creators: Skotak, Nathaniel James
- Member of: Theses and Dissertations
Description
Background: Heart failure is the leading cause of hospitalization in older adults and has the highest 30-day readmission rate of all diagnoses. An estimated 30 to 60 percent of older adults lose some degree of physical function in the course of an acute hospital stay. Few studies have addressed the role of posture and mobility in contributing to, or improving, physical function in older hospitalized adults. No study to date that we are aware of has addressed this in the older heart failure population.
Purpose: To investigate the predictive value of mobility during a hospital stay and patterns of mobility during the month following discharge on hospital readmission and 30-day changes in functional status in older heart failure patients.
Methods: This was a prospective observational study of 21 older (ages 60+) patients admitted with a primary diagnosis of heart failure. Patients wore two inclinometric accelerometers (rib area and thigh) to record posture and an accelerometer placed at the ankle to record ambulatory activity. Patients wore all sensors continuously during hospitalization and the ankle accelerometer for 30 days after hospital discharge. Function was assessed in all patients the day after hospital discharge and again at 30 days post-discharge.
Results: Five patients (23.8%) were readmitted within the 30 day post-discharge period. None of the hospital or post-discharge mobility measures were associated with readmission after adjustment for covariates. Higher percent lying time in the hospital was associated with slower Timed Up and Go (TUG) time (b = .08, p = .01) and poorer hand grip strength (b = -13.94, p = .02) at 30 days post-discharge. Higher daily stepping activity during the 30 day post-discharge period was marginally associated with improvements in SPPB scores at 30 days (b = <.001, p = .06).
Conclusion: For older heart failure patients, increased time lying while hospitalized is associated with slower walking time and poor hand grip strength 30 days after discharge. Higher daily stepping after discharge may be associated with improvements in physical function at 30 days.
Purpose: To investigate the predictive value of mobility during a hospital stay and patterns of mobility during the month following discharge on hospital readmission and 30-day changes in functional status in older heart failure patients.
Methods: This was a prospective observational study of 21 older (ages 60+) patients admitted with a primary diagnosis of heart failure. Patients wore two inclinometric accelerometers (rib area and thigh) to record posture and an accelerometer placed at the ankle to record ambulatory activity. Patients wore all sensors continuously during hospitalization and the ankle accelerometer for 30 days after hospital discharge. Function was assessed in all patients the day after hospital discharge and again at 30 days post-discharge.
Results: Five patients (23.8%) were readmitted within the 30 day post-discharge period. None of the hospital or post-discharge mobility measures were associated with readmission after adjustment for covariates. Higher percent lying time in the hospital was associated with slower Timed Up and Go (TUG) time (b = .08, p = .01) and poorer hand grip strength (b = -13.94, p = .02) at 30 days post-discharge. Higher daily stepping activity during the 30 day post-discharge period was marginally associated with improvements in SPPB scores at 30 days (b = <.001, p = .06).
Conclusion: For older heart failure patients, increased time lying while hospitalized is associated with slower walking time and poor hand grip strength 30 days after discharge. Higher daily stepping after discharge may be associated with improvements in physical function at 30 days.
ContributorsFloegel, Theresa A (Author) / Buman, Matthew P (Thesis advisor) / Hooker, Steven (Committee member) / Dickinson, Jared (Committee member) / DerAnanian, Cheryl (Committee member) / McCarthy, Marianne (Committee member) / Arizona State University (Publisher)
Created2015
Description
This purpose of this study was to develop reliable methods for ultrasound measurements of skeletal muscle architecture, and to identify which specific quadriceps measurements most closely relate to peak isometric torque of the leg extensors. These data were obtained as part of a larger research study and consist of 9 total subjects (4 males, 5 females; age (30.6 ± 13.6yr). Ultrasound images for muscle thickness and pennation angle were obtained for each subject during two separate testing days (separated by 5-10 days). Images were acquired at various anatomical sites of the quadriceps and each image was analyzed using Image J software. Quadriceps muscles assessed for muscle thickness and pennation angle included the vastus lateralis (VL), and vastus intermedius (VI), while rectus femoris (RF) was assessed only for muscle thickness. Peak isometric torque measurements were obtained at 60 degrees of knee angle for knee extension using an isokinetic dynamometer. Results show that the methods chosen for ultrasound measurement produced reliable inter-day results for muscle thickness and pennation angle. VL muscle thickness and pennation angle obtained at the lateral site corresponding to 39% of leg length was highly related to peak isometric torque for knee extension. The results of this study identify specific measurement sites that are related to muscle function. In addition, these data further validate that ultrasound measurement is reliable to measure muscle thickness and pennation angle in skeletal muscle.
ContributorsSkotak, Nathaniel James (Author) / Dickinson, Jared (Thesis director) / Vidt, Meghan (Committee member) / Luden, Nick (Committee member) / School of Nutrition and Health Promotion (Contributor) / Barrett, The Honors College (Contributor)
Created2016-05