Neuromuscular adaptations to perturbation-based balance training using treadmill belt accelerations do not transfer to an obstacle trip in older people: A cross-over randomised controlled trial.

Background: This study examined (i) adaptations in muscle activity following perturbation-based balance training (PBT) using treadmill belt-accelerations or PBT using walkway trips and (ii) whether adaptations during treadmill PBT transfer to a walkway trip.

Methods: Thirty-eight older people (65+ years) undertook two PBT sessions, including 11 treadmill belt-accelerations and 11 walkway trips. Surface electromyography (EMG) was measured bilaterally on the rectus femoris (RF), tibialis anterior (TA), semitendinosus (ST) and gastrocnemius medial head (GM) during the first (T1) and eleventh (T11) perturbations.

Treadmill induced belt-accelerations may not accurately evoke the muscle responses to obstacle trips in older people.

Background: Treadmill belt-accelerations are a commonly utilised surrogate for tripping, but their physiological validity is unknown. This study examined if a treadmill belt-acceleration induces lower limb muscle activation responses similar to a trip on a walkway.

Methods: 38 older people (65+ years) experienced one treadmill belt-acceleration and one walkway obstacle trip in random order.

Safety and Efficacy of Testosterone Therapy on Musculoskeletal Health and Clinical Outcomes in Men: A Systematic Review and Meta-Analysis of Randomized Placebo-Controlled Trials.

Objective: Age-related declines in muscle and bone, alongside a shift toward greater adiposity, contribute to falls and fracture risk. Testosterone is osteogenic, myogenic, and catabolic to fat. As such, we examined the effects of testosterone therapy on musculoskeletal health and clinical outcomes in men.

The effects of optic flow on postural stability: Influence of age and fall risk.

Background: Optic flow provides dynamic information relating to body position and motion with respect to visual frames of reference. This study investigated the effects of optic flow stimuli presented in four directions on postural stability in young and older adults.

Methods: Twenty-five young (20-40 years) and 51 older (≥65 years) people participated in this study, with the older group classified into low fall risk (n = 27), and high fall risk (n = 24) sub-groups.

The Australian and New Zealand Society for Sarcopenia and Frailty Research (ANZSSFR) sarcopenia diagnosis and management task force: Findings from the consumer expert Delphi process.

Objectives: To develop guidelines, informed by health-care consumer values and preferences, for sarcopenia prevention, assessment and management for use by clinicians and researchers in Australia and New Zealand.

Methods: A three-phase Consumer Expert Delphi process was undertaken between July 2020 and August 2021. Consumer experts included adults with lived experience of sarcopenia or health-care utilisation.

Consensus guidelines for sarcopenia prevention, diagnosis and management in Australia and New Zealand.

Background: Sarcopenia is an age-associated skeletal muscle condition characterized by low muscle mass, strength, and physical performance. There is no international consensus on a sarcopenia definition and no contemporaneous clinical and research guidelines specific to Australia and New Zealand. The Australian and New Zealand Society for Sarcopenia and Frailty Research (ANZSSFR) Sarcopenia Diagnosis and Management Task Force aimed to develop consensus guidelines for sarcopenia prevention, assessment, management and research, informed by evidence, consumer opinion, and expert consensus, for use by health professionals and researchers in Australia and New Zealand.

Impact of pathological conditions on postural reflex latency and adaptability following unpredictable perturbations: A systematic review and meta-analysis.

Background: Pathological conditions can impair responses to postural perturbations and increase risk of falls.

Research Question: To what extent are postural reflexes impaired in people with pathological conditions and can exercise interventions shorten postural reflexes?

Methods: MEDLINE, EMBASE, Scopus, SportDiscus and Web of Science were systematically searched for articles comparing muscle activation onset latency in people with pathological conditions to healthy controls following unpredictable perturbations including the effect of exercise interventions (registration: CRD42020170861).

Results: Fifty-three articles were included for systematic review.

Appendicular and mid-thigh lean mass are associated with muscle strength, physical performance, and dynamic balance in older persons at high risk of falls.

Background: Falls in older persons are associated with muscle mass and strength alterations, which may also affect balance parameters. However, the most appropriate combined approach to assess muscle and balance components that predict falls in older persons is still lacking.

Research Question: We hypothesized that appendicular lean and/or mid-thigh mass and muscle strength and performance are positively associated with balance indices and fall risk in older persons.

Association between Circulating Osteoprogenitor Cells and Sarcopenia.

Background: Circulating osteoprogenitor (COP) cells are a surrogate of the bone marrow mesenchymal stem cells with high levels observed in osteoporosis and the initial stages of fracture healing. Conversely, a low percentage of COP cells (%COP) is strongly associated with frailty and disability. However, it is unknown whether %COP is associated with sarcopenia, a musculoskeletal disease closely related to frailty.

Frailty in Stroke-A Narrated Review.

This narrative review provides a summary introduction to the relationship between stroke and physical and cognitive frailty syndromes and the neuro-inflammatory similarities (including inflammaging) between the two. The review argues the potential effects of Post COVID-19 Neurological Syndrome (PCNS, also known as Long COVID) with similar pathophysiology. Many patients who have suffered from acute stroke experience long-lasting symptoms affecting several organs including fatigue, brain fog, reduced physical activity, loss of energy, and loss of cognitive reserve, culminating in the loss of independence and poor quality of life.

Prevalence of Sarcopenia and its Association with Antirheumatic Drugs in Middle-Aged and Older Adults with Rheumatoid Arthritis: A Systematic Review and Meta-analysis.

To examine the prevalence of sarcopenia and its association with antirheumatic drugs in adults with rheumatoid arthritis (RA). This review was registered on PROSPERO and followed PRISMA guidelines. Electronic databases were searched for studies reporting on the prevalence of sarcopenia in adults with RA using any muscle index (muscle mass, strength and/or physical performance) and cutpoints as recommended by established criteria (EWGSOP1/2, AWGS, FNIH, SDOC).

Body composition reference ranges in community-dwelling adults using dual-energy X-ray absorptiometry: the Australian Body Composition (ABC) Study.

Background: Reference ranges for lean mass (LM) and fat mass (FM) are essential in identifying soft tissue disorders; however, no such reference ranges exist for the most commonly used Hologic dual-energy X-ray absorptiometry (DXA) machine in Australia.

Methods: Cross-sectional study of community-dwelling adults (aged 18-88 years) who underwent a Hologic DXA scan at one of three commercialized densitometry centres in Australia. Age-specific and sex-specific percentile curves were generated for LM [LM, appendicular lean mass (ALM), ALM adjusted for height squared (ALM/h ), and ALM adjusted for body mass index (ALM/BMI)] and FM [FM, FM adjusted for height squared (FM/h ), appendicular fat mass, and android and gynoid fat] parameters using the LMS statistical method.

The prevention of osteoporosis and sarcopenia in older adults.

Osteoporosis and sarcopenia are common in older adults. Osteoporosis is a systemic skeletal disease characterized by low bone mass and microarchitectural deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fracture. Bone fractures can result in changes in posture, pain, the need for surgical repair and functional impairment.

Education, occupation and operational measures of sarcopenia: Six years of Australian data.

Objectives: To examine associations of education and occupation with handgrip strength (HGS), lower limb strength (LLS) and appendicular lean mass (ALM).

Methods: Measures of HGS, LLS and ALM (dual-energy X-ray absorptiometry) were ascertained at baseline in 1090 adults (50-80 years, 51% women), ~3 and 5 years. Education and occupation were self-reported, the latter categorised as high-skilled white collar (HSWC), low-skilled white collar (LSWC) or blue collar.

Diagnosis, prevalence, and clinical impact of sarcopenia in COPD: a systematic review and meta-analysis.

Sarcopenia prevalence and its clinical impact are reportedly variable in chronic obstructive pulmonary disease (COPD) due partly to definition criteria. This review aimed to identify the criteria used to diagnose sarcopenia and the prevalence and impact of sarcopenia on health outcomes in people with COPD. This review was registered in PROSPERO (CRD42018092576).

The diagnostic value of the Short Physical Performance Battery for sarcopenia.

Background: Sarcopenia is defined as the age-related loss of muscle mass, strength, and physical performance. The original European Working Group on Sarcopenia in Older Persons (EWGSOP1) definition, and its revision (EWGSOP2), provide new cut-points and alternate measures for sarcopenia diagnosis. However, sarcopenia is rarely diagnosed in clinical settings owing to its labor-intensive diagnostic process.

Age-Related Increases in Marrow Fat Volumes have Regional Impacts on Bone Cell Numbers and Structure.

The increasing levels of bone marrow fat evident in aging and osteoporosis are associated with low bone mass and attributed to reduced osteoblastogenesis. Local lipotoxicity has been proposed as the primary mechanism driving this reduction in bone formation. However, no studies have examined the correlation between high levels of marrow fat volumes and changes in local cellularity.

Associations between osteoporosis, the severity of sarcopenia and fragility fractures in community-dwelling older adults.

Purpose: To investigate the association between bone mineral density (BMD) and the severity of sarcopenia using the revised European Working Group on Sarcopenia in Older People (EWGSOP2) definition.

Methods: BMD [dual energy X-ray absorptiometry (DXA)], appendicular lean mass (DXA), handgrip strength (hydraulic dynamometer) and gait speed (over 4-m) were used to screen for osteoporosis and sarcopenia. Participants were categorized as osteoporotic according to the World Health Organization definition (T score ≤ - 2.

Balance training using virtual reality improves balance and physical performance in older adults at high risk of falls.

Purpose: Exercise programs designed for falls prevention have been proven effective in reducing falls by approximately 21%. Virtual reality may provide a viable alternative intervention for falls prevention. This study compared the effects of virtual reality training using the Balance Rehabilitation Unit (BRU) versus exercise using a modified Otago Exercise Programme (EX) on improving balance and physical performance in the short-term restorative care setting of the Gait and Balance Gym (Gabagym).

The Joint Occurrence of Osteoporosis and Sarcopenia (Osteosarcopenia): Definitions and Characteristics.

Objectives: We sought to examine the associations of osteosarcopenia with physical performance, balance, and falls and fractures in community-dwelling older adults. Additionally, we aimed to determine which clinical outcomes are associated with specific components of osteosarcopenia.

Design: Cross-sectional study.

Osteocalcin and its forms across the lifespan in adult men.

Purpose: Osteocalcin (OC), an osteoblast-specific secreted protein expressed by mature osteoblasts, is used in clinical practice and in research as a marker of bone turnover. The carboxylated (cOC) and undercarboxylated (ucOC) forms may have a different biological function but age-specific reference ranges for these components are not established. Given the different physiological roles, development of reference ranges may help to identify people at risk for bone disease.

Effects of the falls and fractures clinic as an integrated multidisciplinary model of care in Australia: a pre-post study.

Objectives: Traditionally, the approach to fracture prevention has focused on increasing bone mineral density while typically lacking a combined clinical approach to falls prevention and vice versa. To resolve this gap, we implemented and evaluated a novel combined model of care to the assessment and prevention of osteoporosis and falls in the outpatients setting.

Setting: Falls and Fractures Clinic (FFC) at Nepean Hospital (Penrith, NSW, Australia).

Changes in Nutritional Status and Musculoskeletal Health in a Geriatric Post-Fall Care Plan Setting.

Understanding how changes in nutritional status influence musculoskeletal recovery after falling remains unclear. We explored associations between changes in nutritional status and musculoskeletal health in 106 community-dwelling older adults aged ≥65 years, who attended the Falls and Fractures Clinic at Sunshine Hospital in St Albans, Australia after falling. At baseline and after 6 months, individuals were assessed for Mini Nutritional Assessment (MNA), grip strength, gait speed, Timed Up and Go (TUG) test, Short Physical Performance Battery (SPPB), and bone turnover marker levels.

Diagnostic Value of Mid-Thigh and Mid-Calf Bone, Muscle, and Fat Mass in Osteosarcopenia: A Pilot Study.

Osteosarcopenia is defined as the concomitant occurrence of osteoporosis and sarcopenia. Current lack of consensus on sarcopenia definitions, combined with the low sensitivity and specificity of screening methodologies, has resulted in varying prevalences of sarcopenia, and consequently osteosarcopenia diagnosis. Previous research indicates that mid-thigh is a potential surrogate region for the assessment of bone, muscle, and fat mass in a single, efficient and low-radiation dual x-ray absorptiometry (DXA) scan.