Zahra Mosallanezhad

Walking habits and health-related factors in 75-year-old Iranian women and men

An active life style can postpone the aging process, prevent many aspects of functional decline and improve health and quality of life. The aim of this study was to compare elderly people who walked at least 30 min a day with others who walked less, from a gender perspective, regarding perceived health and fitness, physiological capacity and functional performance. A representative sample of 75-year-olds born 1932-33 and living in Tehran, in 2007-2008 was included by randomly selecting 1100 subjects from the latest Iranian census records (1996) by the Statistical Centre of Iran using computerized methods. Participants answered questions regarding health status and physical activity and performed functional tests. Better results for Walkers were observed in most subjective and objective outcome measures. Walkers were less likely to feel generally tired, more likely to have better physical fitness and to have the maximum score on the Falls Efficacy Scale, less likely to feel unstable during walking outdoors and less likely to be dependent or unsafe in ADL. Walkers of both genders performed better in the following tests: chair stand, one leg stance, maximal walking speed and six min walking. The difference between Walkers and Non-Walkers was greater in men. In general, older women and men who walked at least 30 min daily/almost daily showed better results in most health-related outcomes, ADL and functional performance than people who walked less. This study showed gender differences in the level of physical activity and functioning that must be taken into account when planning intervention programs.

Physical activity and physical functioning in Swedish and Iranian 75-year-olds - A comparison

BACKGROUND AND PURPOSE The pattern of population aging is highly complex and contextually based. Cross-national comparisons are helpful to explore related factors. Two cross-sectional studies designed to compare physical activity level, physical functioning and certain health related factors in 75-year-old women and men in Sweden and Iran. MATERIALS AND METHODS Cohorts of 637 Swedish and 851 Iranian 75-year-olds were investigated with the same methods regarding physical activity level, physical functioning and health related factors. RESULTS There were differences in physical activity level (p<0.001), self-reported physical functioning (p<0.001) objective physical functioning (p<0.001), health status (p<0.001) and most socio-demographic aspects between the two countries. Here the Swedish cohort had the advantage. There was no difference between the countries regarding prevalence of vertigo or falls. The only variables where the Iranian cohort had advantage over the Swedes were grip strength and smoking habits. There were larger gender differences in walking habits, self-selected walking speed, timed chair stand, and one-leg stance in Iran, and in grip strength in Sweden, all to the disadvantage of women. CONCLUSIONS Iranian 75-years-olds had a lower physical activity level, a worse lower extremity physical function but a better grip strength, a worse physical health status, but smoked less than their Swedish counterparts. Despite this, there were no differences regarding vertigo or falls. In most aspects, the magnitude of gender differences was about the same and in disadvantage of women, although there were larger differences in Iran in some lower extremity functions.

Cross-cultural adaptation, reliability and validity of the Persian version of the modified falls efficacy scale

Purpose. To translate the Swedish version of the Falls Efficacy Scale (FES), the FES(S), into Persian, and to determine reliability and validity of the scale to be used for Persian speaking elderly people. Method. The ‘forward-backward’ procedure was applied to translate the FES(S) into Persian. A methodological study was then carried out to determine the psychometric properties of the Persian version of the scale. Eighty-one community-dwelling elderly persons (≥65 years) were included. Results. Both reliability and validity of the Persian FES(S) were found to be acceptable (Cronbachs α  ==  0.75, interclass correlation coefficients  ==  0.99, p  <  0.001 and standard errors of measurements  ==  1.82). Low to moderate negative correlations of the total score of the scale with the age of the participants and number of falls in the past year were shown. There were also low to moderate correlations between the Persian FES(S) score and the Mini-Mental State Examination score, duration of walks and physical fitness. The participants who took a daily walk, felt healthy, reported no general tiredness and who had had no fall during the past year rated their self-efficacy higher than did their peers. Conclusions. The present study verified that the Persian FES(S) is a culturally relevant, valid and reliable tool for measuring self-perceived confidence in Iranian older adults.

A structural equation model of the relation between socioeconomic status, physical activity level, independence and health status in older Iranian people.

BACKGROUND AND AIM Health status is an independent predictor of mortality, morbidity and functioning in older people. The present study was designed to evaluate the link between socioeconomic status (SES), physical activity (PA), independence (I) and the health status (HS) of older people in Iran, using structural equation modelling. METHODS Using computerized randomly selection, a representative sample of 851 75-year-olds living in Tehran (2007-2008), Iran, was included. Participants answered questions regarding indicators of HS, SES and also PA and I through interviews. Both measurement and conceptual models of our hypotheses were tested using Mplus 5. Maximum-likelihood estimation with robust standard errors (MLR estimator), chi-square tests, the goodness of fit index (and degrees of freedom), as well as the Comparative Fit Index (CFI), and the Root Mean Square Error of Approximation (RSMEA) were used to evaluate the model fit. RESULTS The measurement model yielded a reasonable fit to the data, χ2=110.93, df=38; CFI=0.97; RMSEA=0.047, with 90% C.I.=0.037-0.058. The model fit for the conceptual model was acceptable; χ2=271.64, df=39; CFI=0.91; RMSEA=0.084, with 90% C.I.=0.074-0.093. SES itself was not a direct predictor of HS (β=0.13, p=0.059) but it was a predictor of HS either through affecting PA (β=0.31, p<0.001) or I (β=0.57, p<0.001). CONCLUSION Socioeconomic status appeared to influence health status, not directly but through mediating some behavioral and self-confidence aspects including physical activity and independence in ADL.

The prevalence, circumstances and consequences of unintentional falls among elderly Iranians: A population study

BACKGROUND AND AIM Falling threatens the health, independence and quality of life of older adults. Information about characteristics and predisposing factors of falls is essential to develop and implement effective preventing measure. The aim of this study was to examine the prevalence, circumstances and consequences of falls among community-dwelling older adults in Tehran, Iran, and scrutinize factors (e.g. demographics) associated with falls. METHODS A cross-sectional study was conducted in Tehran. A total of 653 individuals aged 65 years and over were selected by a stratified random sampling as representing older adults in Tehran. All required data were collected through face-to-face interviews using questionnaires. RESULTS The prevalence of falls was 39.7% and higher in women than in men. For both sexes, most of the falls occurred in the afternoon (n = 135, 52.1%) and at home (n = 209, 80.7%). One-fourth of the falls (23.2%) occurred in a forward direction, mostly among women (60%). For both sexes, one-third of the causes of falls were loss of balance, mostly among women and the oldest persons. Two-hundred and twelve of the fallers reported injuries. The logistic regression showed that female gender, low education and constant worries about living expenses were significantly associated with falls. CONCLUSIONS This study may have provided new insights into the characteristics/ circumstances/ consequences of injurious falls and their relation with age, gender and injury severity in Iran. It may be useful for health policy makers and health providers when designing falls intervention and prevention programs at the community level.

Physiotherapy with and without Superficial Dry Needling Affects Pain and Muscle Strength in Patients with Patellofemoral Pain Syndrome

Objectives: To investigate the clinical efficacy of physiotherapy with and without superficial dry needling on patients with knee pain; patellofemoral pain syndrome. Methods: A randomized clinical trial conducted in 2015, Tehran, Iran. Of patients with patellofemoral pain syndrome, thirty-four subjects were randomly divided into two groups (17 in each group). Group A was subjected to physiotherapy and group B to physiotherapy with superficial dry needling. Only for group B, superficial dry needling was applied during the ten-day sessions of physiotherapy, every other day. The needle remained for 6 minutes at threepoints of the quadriceps muscle, accompanied with needle rotation. Both groups received 10 therapy sessions. For both groups, in the first and tenth sessions, knee pain and quadriceps muscle strength was evaluated. Results: Statistical analysis showed the two variables in each group had significant improvements after the 10 sessions (P<0.05). Comparing the two groups, group B showed more pain reduction based on the visual analog scale (P<0.05). However, according to manual muscle testing method, the muscle strength between both the groups showed no significant difference (P<0.156). Discussion: Physiotherapy with and without superficial dry needling were seen to reduce pain and increase muscle strength of patients with patellofemoral pain syndrome. However, performing physiotherapy with superficial dry needling had a more significant effect on reducing knee pain. Superficial needling can cause many physiological and neurophysiological effects. Through stimulation of pain control mechanisms, it can help in further reduction of pain. A B S T R A C T