Functional reserve in functionally independent elderly persons: a calculation of gait speed and physiological cost

Gonzalez, Paul; Cofré, Rodrigo; Cabello, Máximo Escobar

doi:10.1590/1809-98232016019.150136

Cited by 3 publications

(2 citation statements)

References 32 publications

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“…The term 'functional reserve' has been used to describe individual differences in reserve capacities of other aspects of everyday functioning in the context of aging. For instance, in studies of physical fitness, functional reserve has been separately operationalized to capture interindividual differences in one's capacity to mitigate cardiovascular health and musculoskeletal system deterioration (Goldspink, 2005) and to maintain physical fitness (González, Cofré, & Cabello, 2016). Functional reserve has also been operationalized as a variable to determine person-specific oxygen uptake values (Arnett, Laity, Agrawal, & Cress, 2008).…”

Section: Discussionmentioning

confidence: 99%

Functional reserve: The residual variance in instrumental activities of daily living not explained by brain structure, cognition, and demographics.

Kraal¹,

Massimo²,

Fletcher³

et al. 2021

Neuropsychology

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Objective: Cognitive reserve is a concept that explains individual differences in resilience to brain pathology and susceptibility to poor late-life cognitive outcomes. We evaluate the analogous concept of “Functional Reserve,” defined as the difference between observed functional abilities and those predicted by brain structure, cognitive performance, and demographics. This study aims to validate the construct of functional reserve by testing its utility in predicting clinical outcomes and exploring its predictors. Method: Longitudinal data collected annually for up to 7 years from 1,084 older adults (ndementia = 163; nMCI = 333; nCN = 523) were analyzed. Functional reserve was operationalized as the residual variance in the Lawton-Brody Instrumental Activities of Daily Living (IADL) Scale after accounting for demographics (sex/gender, race, ethnicity, education), neuropathology (gray matter, hippocampal, and white matter hyperintensity volumes), and cognition (executive function, verbal episodic memory, semantic memory, and spatial function). Structural equation models estimated (a) functional reserve’s associations with 7-year changes in clinical diagnosis and disease severity and (b) predictors of functional reserve. Results: Functional reserve was lower in dementia versus cognitively normal individuals. Higher baseline functional reserve was associated with lower concurrent dementia severity and slower clinical progression and attenuated the association of cognition with concurrent dementia severity. Physical function and apathy were the strongest predictors of functional reserve. Conclusions: Results provide preliminary validation of functional reserve for explaining individual differences in susceptibility to IADL dysfunction independent of neuropathology, cognition, and demographics. Physical functioning and apathy are promising modifiable intervention targets to enhance functional reserve in the context of brain atrophy and cognitive decline.

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Section: Discussionmentioning

confidence: 99%

Functional reserve: The residual variance in instrumental activities of daily living not explained by brain structure, cognition, and demographics.

Kraal¹,

Massimo²,

Fletcher³

et al. 2021

Neuropsychology

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“…The differences in WD may be due to constant accelerations and decelerations in gait not occurring on the elliptical track, which are present on a straight track with a delimited length. In this respect, Medina et al (2016) proposed that gait be assessed in older adults on an elliptical track because this track would allow a gait pattern that would better resemble natural conditions, as opposed to a straight unidirectional track, where the displacement would be conditioned by turns. In this sense, Pinochet et al Indicate that the changes in direction that the subject undergoes during the turns on the one-way track cause the walking speed to decrease.…”

Section: Discussionmentioning

confidence: 99%

Comparison of distance covered, physiological cost, and perceived exertion in four six-minute walk test protocols

Muñoz-Cofré,

Sol,

Lizana

et al. 2024

Front. Physiol.

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Objective: There is evidence that indicates that the Walked Distance (WD) in the 6-Minute Walk Test (6MWT) would be sensitive to the type of track and encouragement. The aim of study was compared the impact of track type and verbal encouragement provided in the 6MWT on WD, physiological cost, perceived exertion, and gait efficiency in healthy young adults unfamiliar with the test.Method: WD, heart rate, subjective sensation of dyspnea (SSD), and fatigue (SSF) were measured in four 6MWT protocols: i) 30 m linear track and protocolized encouragement (LT + PE), ii) 30 m linear track and constant encouragement (LT + CE), iii) 81 m elliptical track and protocolized encouragement (ET + PE), and iv) 81 m elliptical track and constant encouragement (ET + CE). In addition, the Gait Efficiency Index (GIE) associated with physiological cost, dyspnea and fatigue was calculated and compared between the different protocols.Results: The WD was significantly higher in the ET + CE protocol. The percentage of the heart rate reserve used (%HRRu) at minute 6 was higher in the ET + CE protocol. The SSD and SSD had difference in startup time between the protocols. The GEI was higher in %HRRu, SSD, and SSF for the ET + CE protocol.Conclusion: The ET + CE protocol showed a significant increase in WD during the 6MWT in healthy young adults. Although it obtained the highest physiological cost, it did not present perceptual differences when entering cardiopulmonary assessment windows relevant to a more efficient test for the participant. It is advisable to discuss, based on the findings, the fundamental objective of the 6MWT and national and international recommendations to achieve a result as close as possible to the real maximal effort.

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Physical Function Tests Are Potential Tools to Identify Low Physical Resilience in Women after Breast Cancer Treatment

Martins

Oliveira

Oliveira-Júnior

et al. 2023

Muscles

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Background: This study sought to investigate whether different physical function tests (objective measures of physical performance) may identify a low physical resilience in breast cancer survivors (BCS). Methods: This analytical cross-sectional study evaluated 146 BCS and 69 age-matched women without breast cancer history. The different times after the end of treatment were used as criteria for group division. Participants were divided into four groups: control (CT: n = 69–women without breast cancer history); <1.0 years after the end of treatment (<1 YAT: n = 60); 1–3.9 years after the end of treatment (1–3.9 YAT: n = 45); and ≥4 years after the end of treatment (>4 YAT: n = 41). Physical function was evaluated by 4 m walk test (4-MWT), five-times-sit-to-stand test (FTSST), timed up and go test (TUG), and short physical performance battery (SPPB). Age, menopausal status, smoking, number of medications, level of physical activity, body mass index, and muscle strength were used as confounding variables in ANCOVA. Results: All groups that underwent cancer treatment (<1 YAT, 1–3.9 YAT and ≥4 YAT) had lower physical performance (p < 0.001) identified by 4 MWT, TUG, and FTSST when compared to the CT group. For the SPPB, the <1 YAT and ≥4 YAT groups had lower performance (p = 0.005) when compared to the CT. Conclusions: The different physical function tests can be used to identify a low physical resilience in BCS.

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Functional reserve in functionally independent elderly persons: a calculation of gait speed and physiological cost

Cited by 3 publications

References 32 publications

Functional reserve: The residual variance in instrumental activities of daily living not explained by brain structure, cognition, and demographics.

Functional reserve: The residual variance in instrumental activities of daily living not explained by brain structure, cognition, and demographics.

Comparison of distance covered, physiological cost, and perceived exertion in four six-minute walk test protocols

Physical Function Tests Are Potential Tools to Identify Low Physical Resilience in Women after Breast Cancer Treatment

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