Identifying determinants of physical activity in older patients with musculoskeletal disorders undergoing rehabilitation: Comparison of two distinct models using structural equation modeling

IF 2.4 4区医学 Q3 GERIATRICS & GERONTOLOGY Geriatrics & Gerontology International Pub Date : 2024-12-15 DOI:10.1111/ggi.15022

Masashi Kanai, Kazuki Yoshida, Hiroki Okada, Takuro Ohtsubo, Katsuhiro Ueno, Masafumi Nozoe

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Abstract

Aim

Mobility restrictions cause older adults with musculoskeletal disorders to have lower levels of physical activity. However, the determinants of their physical activity during hospitalization are unclear. We aimed to compare two conceptual frameworks using structural equation modeling to identify factors influencing physical activity in older patients with musculoskeletal disorders.

Methods

This cross-sectional study included older patients with musculoskeletal disorders at a single convalescent rehabilitation hospital. Physical activity was objectively measured using a triaxial accelerometer. We utilized structural equation modeling to contrast two conceptual frameworks: (i) the sarcopenia/nutrition/activities of daily living model, and (ii) the age-related deconditioning/activities of daily living model. The models' goodness-of-fit was evaluated, including root mean square approximation error, goodness-of-fit index (GFI), adjusted GFI and Akaike information criterion.

Results

We enrolled 274 older patients (age 78.0 years; 42 men, 232 women) with musculoskeletal disorders. Among them, 123 (44.9%) were diagnosed with sarcopenia and 69 (25.2%) with malnutrition. The goodness-of-fit of the (ii) model (root mean square approximation error = 0.068, GFI = 0.958, adjusted GFI = 0.909, Akaike information criterion = 5780.875) was superior to the (i) model (root mean square approximation error = 0.080, GFI = 0.953, adjusted GFI = 0.887, Akaike information criterion = 5791.429).

Conclusions

We discovered that the age-related deconditioning/activities of daily living model effectively explained physical activity in hospitalized older patients with musculoskeletal disorders. A comprehensive approach considering age-related changes, such as sarcopenia and malnutrition, might offer a simpler and more effective framework for understanding and promoting physical activity in this demographic. Geriatr Gerontol Int 2025; 25: 160–166.

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在接受康复治疗的老年肌肉骨骼疾病患者中确定体力活动的决定因素：使用结构方程模型的两种不同模型的比较

目的：活动受限导致患有肌肉骨骼疾病的老年人身体活动水平降低。然而，他们在住院期间身体活动的决定因素尚不清楚。我们的目的是使用结构方程模型来比较两种概念框架，以确定影响老年肌肉骨骼疾病患者身体活动的因素。方法：这项横断面研究包括在一家康复康复医院的老年肌肉骨骼疾病患者。使用三轴加速度计客观测量身体活动。我们利用结构方程模型来对比两个概念框架：(i)肌肉减少/营养/日常生活活动模型，（ii）与年龄相关的日常生活活动模型。评估模型的拟合优度，包括均方根近似误差、拟合优度指数（GFI）、调整后的GFI和赤池信息准则。结果：我们招募了274例老年患者(年龄78.0岁；42名男性，232名女性)患有肌肉骨骼疾病。其中肌肉减少症123例（44.9%），营养不良69例（25.2%）。（ii）模型的拟合优度（均方根近似误差= 0.068,GFI = 0.958，调整后的GFI = 0.909，赤池信息准则= 5780.875）优于(i)模型（均方根近似误差= 0.080,GFI = 0.953，调整后的GFI = 0.887，赤池信息准则= 5791.429）。结论：我们发现，与年龄相关的日常生活功能减退/活动模型有效地解释了住院老年肌肉骨骼疾病患者的身体活动。综合考虑年龄相关的变化，如肌肉减少症和营养不良，可能会为理解和促进这一人群的体育活动提供一个更简单、更有效的框架。Geriatr Gerontol Int 2024；••: ••-••.

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来源期刊

Geriatrics & Gerontology International 医学-老年医学

CiteScore

5.50

自引率

6.10%

发文量

189

审稿时长

4-8 weeks

期刊介绍： Geriatrics & Gerontology International is the official Journal of the Japan Geriatrics Society, reflecting the growing importance of the subject area in developed economies and their particular significance to a country like Japan with a large aging population. Geriatrics & Gerontology International is now an international publication with contributions from around the world and published four times per year.