This study compares the effects of two resistance training programs in peripheral and respiratory musculature on muscle mass and strength and physical performance and identifies the appropriate muscle mass parameter for assessing the intervention effects. Thirty-seven institutionalized older Spanish adults with sarcopenia were analyzed: control group (n = 17), respiratory muscle training group (n = 9), and peripheral muscle training group (n = 11). Measured outcomes were appendicular skeletal muscle mass (ASM/height, ASM/weight, and ASM/BMI), isometric knee extension, arm flexion and handgrip strength, maximal inspiratory and expiratory pressures, and gait speed pre- and postintervention. Trained groups participated in a 12-week program and improved in maximum static inspiratory pressure, maximum static expiratory pressure, knee extension, and arm flexion (p < .05), whereas nonsignificant changes were found in gait speed and ASM indexes pre- and postintervention in the three groups. In conclusion, resistance training improved skeletal muscle strength in the studied population, and any ASM index was found to be appropriate for detecting changes after physical interventions.

Background: Recently, the European Working Group on Sarcopenia in Older People (EWGSOP2) has updated the sarcopenia definition based on objective evaluation of muscle strength, mass and physical performance. The aim of this study was to analyse the relationship between sarcopenia and clinical aspects such as functionality, comorbidity, polypharmacy, hospitalisations and falls in order to support sarcopenia screening in institutionalised older adults, as well as to estimate the prevalence of sarcopenia in this population using the EWGSOP2 new algorithm. Methods: A multicentre cross-sectional study was conducted on institutionalised older adults (n = 132, 77.7% female, mean age 82 years). Application of the EWGSOP2 algorithm consisted of the SARC-F questionnaire, handgrip strength (HG), appendicular skeletal muscle mass index (ASMI) and Short Physical Performance Battery (SPPB). Clinical study variables were: Barthel Index (BI), Abbreviated Charlson’s Comorbidity Index (ACCI), number of medications, hospital stays and falls. Results: Age, BI and ACCI were shown to be predictors of the EWGSOP2 sarcopenia definition (Nagelkerke’s R-square = 0.34), highlighting the ACCI. Sarcopenia was more prevalent in older adults aged over 85 (p = 0.005), but no differences were found according to gender (p = 0.512). Conclusion: BI and the ACCI can be considered predictors that guide healthcare professionals in early sarcopenia identification and therapeutic approach.

Objectives: The purpose of this study was to conduct a review of randomized controlled trials (RCTs) to determine the treatment effectiveness of the combination of manual therapy (MT) with other physical therapy techniques. Methods: Systematic searches of scientific literature were undertaken on PubMed and the Cochrane Library (2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014). The following terms were used: "patellofemoral pain syndrome," "physical therapy," "manual therapy," and "manipulation." RCTs that studied adults diagnosed with patellofemoral pain syndrome (PFPS) treated by MT and physical therapy approaches were included. The quality of the studies was assessed by the Jadad Scale. Results: Five RCTs with an acceptable methodological quality (Jadad ≥ 3) were selected. The studies indicated that MT combined with physical therapy has some effect on reducing pain and improving function in PFPS, especially when applied on the full kinetic chain and when strengthening hip and knee muscles. Conclusions: The different combinations of MT and physical therapy programs analyzed in this review suggest that giving more emphasis to proximal stabilization and full kinetic chain treatments in PFPS will help better alleviation of symptoms. (J Chiropr Med 2017;16:139-146)

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IOS PressBalasch I Bernat, M.; Balasch Parisi, S.; Noe Sebastian, E.; Dueñas Moscardo, L.; Ferri Campos, J.; Lopez Bueno, L. (2015). Determining cut-off points in functional assessment scales in stroke. NeuroRehabilitation. 37(2):165-172. doi:10.3233/NRE-151249.2 "Determining cut-off points in/for functional poststroke assessment scales" INTRODUCTIONAppropriate assessment of post-stroke patients is an important element for quality of care and is a constant recommendation in all the International Guidelines for the management of these patients. Use of a standardized assessment helps identify and quantify the degree of neurological deficits, facilitate communication between clinicians, provides outcome information, and helps treatment selection to increase efectiveness in rehabilitation. A wide variety of well-validated instruments for the assessment of functioning and disability have been developed [1][2][3][4][5], which enable the extent of the sequelae of a stroke, and subsequent recovery, to be determined [6]. The Barthel Index (BI), Functional Independence Measurement (FIM) and FunctionalAssessment Measurement (FAM) scales have been validated and globally used for functional assessment in this population. Although these scales can capture minimal changes in physical functioning, they have limitations in their application. Because these scales yield ordinal values, researchers or practitioners may have difficulties in understanding and interpreting the clinical meaning of total scores or score changes when these occur. Interpretation of each instrument's raw score is limited to numeric increases or decreases in total score. In order to provide more interpretable information on post-stroke outcomes, several assessment scales have been stratified or divided into categories, which distinguish different levels of recovery [4,5,[7][8][9].Several cut-off points have been suggested for the categorization of some of these instruments. The assessment scales most commonly used in order to establish such cut-off points are the BI and the Modified Rankin Scale (mRS) [2,9,10]. Less frequently, the FIM has also been used in a variety of such studies [5,11]. While the cut-off points used in the functional assessment scales such as the BI [2,9,[12][13][14][15][16]] and the FIM [11] are highly variable, 3 a more consistent stratification of recovery levels has been determined for the mRS [9,16].. However, mRS represents a unidimensional scale heavily weighted toward global disability (in particular physical disability), so other instruments have been developed in an effort to reflect nonphysical attributes essential to a person's self-maintenance and well-being, such as cognition, behavior and social functioning. The Differential Outcome Scale (DOS) is one of these multidimensional tools listed within the functioning and disability component of the International Classification of Functioning, Disability and Health (ICF) framework [Tate et al., 2013]. Since the use of multidimensional scales is not generalized, the categoriza...