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ASME 2008 Engineering System Design and Analysis Conference ESDA 2008 July 7-9, 2008, Haifa, Israel. Physical and Psychical Conditions Decline of Older people with Age, Measured by Functional Reach Test and by Mini Mental State Examination. Lucilla Monteleone Roberto Steindler.

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asme 2008 engineering system design and analysis conference esda 2008 july 7 9 2008 haifa israel

ASME 2008 Engineering System Design and Analysis ConferenceESDA 2008July 7-9, 2008, Haifa, Israel

Physical and Psychical Conditions Decline of Older people with Age, Measured by Functional Reach Test and by Mini Mental State Examination

Lucilla Monteleone

Roberto Steindler

Marianna Costarella

Stefano Maria Zuccaro

aim of the work
Aim of the work

Tests considered Population examined

  • There are several tests to value the psychophysical characteristics of older people and, among all, the most suitable to this aim are here considered the Functional Reach (FR) test, as an index of the aptitude to maintain balance in upright position, and the Mini Mental State Examination (MMSE), as a global index of cognitive abilities.
  • The sample of older people we have analysed concerns 50 healthy subjects divided into three groups according to the age:
    • 15 from 55 to 64 years old
    • 19 from 65 to 74 years old
    • 16 more than 75 years old.

Physical and Psychical Conditions Decline of Older people with Age, Measured by Functional Reach Test and by Mini Mental State Examination

psychical test mmse
Psychical test (MMSE)

Mini Mental State Examination

  • The MMSE is a means, with international validation, of global estimation of the cognitive function of older subjects.
  • It is a test easy to be given and executed; it consists in 11 items, each one corresponding to a cognitive functional area, as time-space orientation, attention and calculus abilities, short period memory, recall ability, praxis-constructive and mind ability.
  • The total score is 30/30 in normal cognitive performances.
  • An MMSE score >24/30 indicates cognitive abilities inside normal values for subjects more than 65 years old.

Physical and Psychical Conditions Decline of Older people with Age, Measured by Functional Reach Test and by Mini Mental State Examination

functional reach
Functional Reach
  • The Functional Reach is defined as the maximum forward displacement that a subject can succeed in achieving, with a closed fist, starting from an upright position with the dominant arm extended forward so as to form a right angle with the torso, while, simultaneously maintaining a fixed support, and the fist always at the same level throughout the movement; the torso must not rotate during the test

Physical and Psychical Conditions Decline of Older people with Age, Measured by Functional Reach Test and by Mini Mental State Examination

functional reach fr test
Functional Reach (FR) test
  • The Functional Reach (FR) test consists:
    • first in the measurement of the anthropometric characteristics: gender, age, height
    • then in the execution of the test itself by measuring the value of the FR
    • and finally in the study of the upright posture by the analysis of the Centre of Pressure (COP) trend.

Characteristics of the examined subjects (whole people)

According to the exclusion criteria, each subject has first undergone a short anamnesis interview to control his health conditions: the subjects have been selected taking care of two important criteria: ability of keeping upright position for at least 10 minutes, and cognitive function in the normal ranges according to the age (MMSE>24/30). Then anthropometric data (height, body mass etc.) have been measured.

Physical and Psychical Conditions Decline of Older people with Age, Measured by Functional Reach Test and by Mini Mental State Examination

functional reach fr test1
Functional Reach (FR) test
  • The Functional Reach (FR) test consists:
    • first in the measurement of the anthropometric characteristics: gender, age, height
    • then in the execution of the test itself by measuring the value of the FR
    • and finally in the study of the upright posture by the analysis of the Centre of Pressure (COP) trend.

Characteristics of the examined subjects (male people)

Physical and Psychical Conditions Decline of Older people with Age, Measured by Functional Reach Test and by Mini Mental State Examination

functional reach fr test2
Functional Reach (FR) test
  • The Functional Reach (FR) test consists:
    • first in the measurement of the anthropometric characteristics: gender, age, height
    • then in the execution of the test itself by measuring the value of the FR
    • and finally in the study of the upright posture by the analysis of the Centre of Pressure (COP) trend.

Characteristics of the examined subjects (female people)

Physical and Psychical Conditions Decline of Older people with Age, Measured by Functional Reach Test and by Mini Mental State Examination

functional reach fr test3
Functional Reach (FR) test
  • The Functional Reach (FR) test consists:
    • first in the measurement of the anthropometric characteristics: gender, age, height
    • then in the execution of the test itself and in the measure of the value of the FR
    • and finally in the study of the upright posture by the analysis of the Centre of Pressure (COP) trend.

All the subjects have been invited to stand barefoot on the pressure map sensor and to keep the upright position with one arm at a right angle with the torso and with the fist closed. The subject remains for about 5 seconds in this position and then he performs the FR test extending forward as far as possible compatibly with his conditions; then the subjects goes back to the starting position standing up some seconds more; the total time required for the test is 15 seconds and during this period the heels must not lift. The test must be repeated three times and each time FR and ΔCOP are measured.

Physical and Psychical Conditions Decline of Older people with Age, Measured by Functional Reach Test and by Mini Mental State Examination

functional reach fr test4
Functional Reach (FR) test
  • The Functional Reach (FR) test consists:
    • first in the measurement of the anthropometric characteristics: gender, age, height
    • then in the execution of the test itself and in the measure of the value of the FR
    • and finally in the study of the upright posture by the analysis of the Centre of Pressure (COP) trend.

Physical and Psychical Conditions Decline of Older people with Age, Measured by Functional Reach Test and by Mini Mental State Examination

functional reach fr test5
Functional Reach (FR) test
  • The Functional Reach (FR) test consists:
    • first in the measurement of the anthropometric characteristics: gender, age, height
    • then in the execution of the test itself and in the measure of the value of the FR
    • and finally in the study of the upright posture by the analysis of the Centre of Pressure (COP) trend.

Physical and Psychical Conditions Decline of Older people with Age, Measured by Functional Reach Test and by Mini Mental State Examination

slide11

Characteristics:

  • Thickness:150 mm
  • Range: 400 – 500 kPa
  • No hysteresis
  • No response delay

kapton

Conductive strips

Sensor of 80x80=6400 sensing elements

velostat

Dimentions: 40x40 cm2

kapton

Lateral view

row

velostat

Contactresistences

column

kapton

The P-mat sensor

Physical and Psychical Conditions Decline of Older people with Age, Measured by Functional Reach Test and by Mini Mental State Examination

functional reach fr test6
Functional Reach (FR) test
  • The Functional Reach (FR) test consists:
    • first in the measurement of the anthropometric characteristics: gender, age, height
    • then in the execution of the test itself and in the measure of the value of the FR
    • and finally in the study of the upright posture by the analysis of the Centre of Pressure (COP) trend.

From each acquired pressure map it is possible to calculate COP coordinates and therefore to determine its trends in the anterior-posterior and in the medial-lateral directions. The difference between the anterior-posterior at the beginning of the test and at the maximum extension gives the displacement of the COP, DCOP. It must be pointed out that only the anterior-posterior component of the displacement is considered significant for the test

Physical and Psychical Conditions Decline of Older people with Age, Measured by Functional Reach Test and by Mini Mental State Examination

cop trends

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acquisitions

acquisitions

COP trends

Examples

slow and regular forward trend till the maximum extension and a back trend to the upright position with the same features

a forward trend till the maximum extension characterized by small steps and a fast back trend to the upright position

a short initial back displacement then a forward trend with an intermediate stop before the maximum extension and a fast back trend to the upright position is quick

a very fast forward trend till the maximum extension and an equal fast back trend with an intermediate stop to the upright position

Physical and Psychical Conditions Decline of Older people with Age, Measured by Functional Reach Test and by Mini Mental State Examination

global results
Global results

Whole people

  • The first four parameters show a predictable loss both of cognitive abilities and of physical performances with the increase of age.
  • The Fisher test to the four examined parameters, only the 55-64 year group is significantly different from the other two (p>99% for all the four parameters): the difference of the data between the other two groups is not statistically significant (p<95% in the four cases). Shortly there is a dramatic fall of the psychophysical features in the people over 65.

Physical and Psychical Conditions Decline of Older people with Age, Measured by Functional Reach Test and by Mini Mental State Examination

global results1
Global results

Male people

  • With regard to the MMSE, the results are quite similar: there is a small prevalence of male subjects in the first two groups and a little prevalence of the female subjects in the oldest group; none of these three differences is statistically significant.
  • With regard to the FR, the male subjects have superior performances in all the three groups; the differences, even if considerable in some cases, are not statistically significant (p<95%).

Physical and Psychical Conditions Decline of Older people with Age, Measured by Functional Reach Test and by Mini Mental State Examination

global results2
Global results

Female people

  • The ratios FR/H show very small differences; the differences are quite not significant.
  • Also the DCOP don’t show remarkable differences; none of the two genders is superior to the other; statistic differences are not significant.
  • The ratios MMSE/FR show that the decrease of physical performances compared to cognitive abilities is greater in the male subjects; however the high dispersions of data (look at standard deviations) make the differences not significant.

Physical and Psychical Conditions Decline of Older people with Age, Measured by Functional Reach Test and by Mini Mental State Examination

discussion
Discussion
  • There is a higher and more significant decrease of psycho-motor and cognitive performances getting from the first to the other two groups of age; what above could mean a critic “threshold” level of the psycho-cognitive damage of each subject.
  • The results don’t show any prevalence of the male people with regard to the female one, both from a physical and from a psychical point of view; in fact even if male subjects look as being superior to female subjects in physical performances, this superiority is valid only with regard to absolute values of the performances (FR), not to the relative ones (ratios FR/H).

Physical and Psychical Conditions Decline of Older people with Age, Measured by Functional Reach Test and by Mini Mental State Examination

discussion1
Discussion
  • It could be assumed that a regular physical activity, that improves the psycho-physical performances of older people through an improvement of the physical form indexes (aerobic ability, muscular strength, balance), could also be a protective element for older subjects in the terms of cognitive and subsequently physical functional abilities.
  • The tests have been executed during two months. The authors think that it might be considerable, in order to estimate psycho-physical trends with age in one subject, to repeat the tests on the same subjects after 2 or 3 years.

Physical and Psychical Conditions Decline of Older people with Age, Measured by Functional Reach Test and by Mini Mental State Examination

thank you
Thank you

Physical and Psychical Conditions Decline of Older people with Age, Measured by Functional Reach Test and by Mini Mental State Examination