More solid data are needed regarding the application of neuromuscular electrical stimulation (NMES) in the paretic hand following a stroke. A randomised clinical trial was conducted to compare the effects of two NMES protocols with different stimulation frequencies on upper limb motor impairment and function in older adults with spastic hemiparesis after stroke. Sixty nine outpatients were randomly assigned to the control group or the experimental groups (NMES with 50 Hz or 35 Hz). Outcome measures included motor impairment tests and functional assessment. They were collected at baseline, after 4 and 8 weeks of treatment, and after a follow-up period. NMES groups showed significant changes (p < 0.05) with different effect sizes in range of motion, grip and pinch strength, the Modified Ashworth Scale, and the muscle electrical activity in the extensors of the wrist. The 35 Hz NMES intervention showed a significant effect on Barthel Index. Additionally, there were no significant differences between the groups in the Box and Block Test. Both NMES protocols proved evidence of improvements in measurements related to hand motor recovery in older adults following a stroke, nevertheless, these findings showed that the specific stimulation frequency had different effects depending on the clinical measures under study.
Aim
The aim of this study was to assess the internal consistency, hypothesis testing and criterion‐related validity of the Spanish versions of the Kihon Checklist (KCL) – the original 25‐item and reduced 15‐item versions – for screening frailty in community‐dwelling older adults.
Methods
A cross‐sectional study was carried out between March and September 2018 in Valencia province (Spain). A sample of 251 participants was recruited. Construct validity was assessed using four different frailty instruments, and alternative measures corresponding to the KCL domains (handgrip strength, gait speed, the Short Physical Performance Battery, skeletal muscle mass index, physical activity level, functional status, cognitive function, depressive mood, health‐related quality of life and nutritional status). Fried's Frailty Phenotype was used to evaluate criterion validity.
Results
Internal consistency assessed with Kuder–Richardson Formula had a value of 0.69 for the 25‐item version, slightly lower than the usual 0.7 for considering good reliability, and 0.71 for the 15‐item version. There were significant correlations between KCL versions and Fried's Frailty Phenotype, Edmonton Scale, Tilburg Indicator and FRAIL Scale. Consistent significant correlations were also obtained with all frailty measurements and instrumental activities of daily living, physical strength, eating, socialization, and mood domains of the KCL. The KCL closely correlated with other standardized measurements of physical function, cognitive function, depressive mood, and health‐related quality of life. The KCL also showed satisfactory diagnostic accuracy for frailty (area under the curve 0.891 for KCL‐25; area under the curve 0.857 for KCL‐15). The optimal cut‐off points were 5/6 and 3/4, respectively.
Conclusions
The findings suggest that both versions of the KCL, especially KCL‐15, showed adequate evidence of validity and internal consistency as a preliminary screening of frailty among community‐dwelling older adults in Spain. Geriatr Gerontol Int 2021; 21: 262–267.
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