Department of Biomedical Engineering, University of Arizona, 1230 N Cherry Avenue, Tucson, AZ, 85719, USA.
Division of Geriatrics, General Internal Medicine and Palliative Medicine, Department of Medicine, University of Arizona, Tucson, USA.
BMC Geriatr. 2022 Mar 14;22(1):199. doi: 10.1186/s12877-022-02849-3.
Previous research showed association between frailty and an impaired autonomic nervous system; however, the direct effect of frailty on heart rate (HR) behavior during physical activity is unclear. The purpose of the current study was to determine the association between HR increase and decrease with frailty during a localized upper-extremity function (UEF) task to establish a multimodal frailty test.
Older adults aged 65 or older were recruited and performed the UEF task of rapid elbow flexion for 20 s with the right arm. Wearable gyroscopes were used to measure forearm and upper-arm motion, and electrocardiography were recorded using leads on the left chest. Using this setup, HR dynamics were measured, including time to peak HR, recovery time, percentage increase in HR during UEF, and percentage decrease in HR during recovery after UEF.
Fifty-six eligible participants were recruited, including 12 non-frail (age = 76.92 ± 7.32 years), and 40 pre-frail (age = 80.53 ± 8.12 years), and four frail individuals (age = 88.25 ± 4.43 years). Analysis of variance models showed that the percentage increase in HR during UEF and percentage decrease in HR during recovery were both 47% smaller in pre-frail/frail older adults compared to non-frails (p < 0.01, effect size = 0.70 and 0.62 for increase and decrease percentages). Using logistic models with both UEF kinematics and HR parameters as independent variables, frailty was predicted with a sensitivity of 0.82 and specificity of 0.83.
Current findings showed evidence of strong association between HR dynamics and frailty. It is suggested that combining kinematics and HR data in a multimodal model may provide a promising objective tool for frailty assessment.
先前的研究表明衰弱与自主神经系统受损之间存在关联；然而，衰弱对体力活动中心率（HR）变化的直接影响尚不清楚。本研究的目的是确定 HR 增加和减少与衰弱之间在局部上肢功能（UEF）任务中的关联，以建立一种多模态衰弱测试。
招募年龄在 65 岁或以上的老年人，并使用右臂进行 20 秒的快速肘部弯曲 UEF 任务。可穿戴陀螺仪用于测量前臂和上臂运动，心电图通过左胸导联记录。使用此设置，可以测量 HR 动态，包括 HR 峰值时间、恢复时间、UEF 期间 HR 增加的百分比和 UEF 恢复后 HR 减少的百分比。
共招募了 56 名符合条件的参与者，包括 12 名非虚弱（年龄=76.92±7.32 岁）、40 名虚弱前期（年龄=80.53±8.12 岁）和 4 名虚弱个体（年龄=88.25±4.43 岁）。方差分析模型表明，与非虚弱者相比，虚弱前期/虚弱老年人 UEF 期间 HR 增加百分比和 UEF 恢复期间 HR 减少百分比分别低 47%（p<0.01，增加和减少百分比的效应量分别为 0.70 和 0.62）。使用 UEF 运动学和 HR 参数作为独立变量的逻辑模型，虚弱的预测敏感性为 0.82，特异性为 0.83。
目前的研究结果表明 HR 动力学与衰弱之间存在很强的关联。建议在多模态模型中结合运动学和 HR 数据，可能为衰弱评估提供一种有前途的客观工具。
