M.-C. Picot

Physical function decline and degradation of postural sway dynamics in asymptomatic sedentary postmenopausal women

BackgroundPostural control is an important aspect of physical functioning.ObjectiveTo determine whether postural sway complexity could discriminate asymptomatic sedentary postmenopausal women with normal or subnormal physical function from those with lower physical function.DesignCross-sectional study.SettingDepartment of Geriatrics, University Hospital of Montpellier.Participants126 community-dwelling women aged 55 to 76 recruited though public meetings aimed at promoting physical activity in postmenopausal women.MeasurementsWomen were asked to stand still on a force platform, either with eyes open (EO) or eyes closed (EC). Physical function was estimated using the Six-Minute Walking Distance (6MWD) test, expressed as a percentage of the predicted 6MWD (%-pred 6MWD) based on age, gender, body height, and weight. In addition to traditional stabilometric measures, dynamical measures (percentage of determinism of recurrence quantification analysis [DETRQA], sample entropy [SampEn] and complexity index of multiscale entropy [CIMSE]) were used to quantify the complexity of center of pressure (COP) time series (DETRQA: predictability, SampEn: regularity, CIMSE: multiscale regularity).ResultsNone of the traditional stabilometric measures differentiated women with lower (%-pred 6MWD ≤ 85.5%) from those with subnormal or normal (%-pred 6MWD > 85.5%) physical function. Conversely, women with lower physical function showed lower SampEn values in the AP direction in both EO and EC conditions, as well as lower SampEn and higher DETRQA values in the ML direction in EC condition. No significant difference in the CIMSE values was found between the two groups.ConclusionLower physical function was found to be associated with lower postural sway complexity (higher regularity and predictability) in asymptomatic sedentary postmenopausal women, especially in the absence of vision. Future work is needed to determine whether a decrease in postural sway complexity could predict future decline in physical function in these women.

Living Lab MACVIA-LR Équilibre et prévention des chutes

La Presse Medicale - In Press.Proof corrected by the author Available online since vendredi 16 octobre 2015

Effect of a 6-month brisk walking program on walking endurance in sedentary and physically deconditioned women aged 60 or older: A randomized trial

BackgroundWalking endurance is a predictor of healthy ageing.ObjectiveTo examine if a 6-month brisk walking program can increase walking endurance in sedentary and physically deconditioned older women.Trial designRandomized controlled trial.SettingWomen recruited from public meetings aimed at promoting physical activity in women aged 60 or older.Subjects121 women aged 65.7 ± 4.3 years, with sedentary lifestyle (Physical Activity Questionnaire for the Elderly score < 9.4), and a 6-minute walking distance (6MWD) below normal value based on their gender, age, and body weight, and weight.MethodsWomen were randomly assigned to a 150 min/week brisk walking program (two supervised sessions and one session on their own per week) for six months (exercisers) (n=61) or a control group with physical activity allowed freely (n=60).OutcomeThe primary outcome was relative change in 6MWD.Results54/61 exercisers and 55/60 control subjects completed the program and data analysis was possible for 51 exercisers and 47 controls. At baseline, 6MWD was on average 23.1% and 22.5% below age-matched norms in exercisers and controls, respectively. Attendance rate for supervised sessions was 92% in exercisers. The 6MWD increased more significantly in exercisers than in controls (mean increase of 41.5% vs 11.0 %; p<0.0001). Over the 6-month program, 38 exercisers (74.5%) vs 5 controls (10.6%) had a 6MWD over the age-matched norm (p<0.0001). Exercisers with the highest tertile of 6MWD improvement (>46%) were those with baseline lowest values of 6MWD (p=0.001) and highest values of body mass index (BMI) (p<0.01).ConclusionPresent results support recommendation that brisk walking programs should be encouraged to improve walking endurance in physically deconditioned women aged 60 or older, especially in those with high BMI.