Free-Living Sit-to-Stand Characteristics as Predictors of Lower Extremity Functional Decline Among Older Adults

Antti Löppönen; Laura Karavirta; Taija Finni; Lotta Palmberg; Erja Portegijs; Taina Rantanen; Christophe Delecluse; Evelien Van Roie; Timo Rantalainen

doi:10.1249/MSS.0000000000003470

Free-Living Sit-to-Stand Characteristics as Predictors of Lower Extremity Functional Decline Among Older Adults

Med Sci Sports Exerc. 2024 May 15. doi: 10.1249/MSS.0000000000003470. Online ahead of print.

Authors

Antti Löppönen, Laura Karavirta¹, Taija Finni², Lotta Palmberg¹, Erja Portegijs³, Taina Rantanen¹, Christophe Delecluse⁴, Evelien Van Roie⁴, Timo Rantalainen¹

Affiliations

¹ Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyväskylä, Jyväskylä, FINLAND.
² Faculty of Sport and Health Sciences and Neuromuscular Research Center, University of Jyväskylä, Jyväskylä, FINLAND.
³ University of Groningen, University Medical Center Groningen, Center of Human Movement Sciences, Groningen, THE NETHERLANDS.
⁴ Department of Movement Sciences, Physical Activity, Sports and Health Research Group, KU Leuven, Leuven, BELGIUM.

PMID: 38768057
DOI: 10.1249/MSS.0000000000003470

Abstract

Purpose: Habitual strength and power-demanding activities of daily life may support the maintenance of adequate lower-extremity functioning with ageing, but this has been sparingly explored. Hence, we examined whether the characteristics of free-living sit-to-stand (STS) transitions predict a decline in lower-extremity functioning over a 4-year follow-up.

Methods: 340 community-dwelling older adults (60% women, age 75, 80 or 85 years) participated in this prospective cohort study. At baseline, a thigh-worn accelerometer was used continuously (3-7 days) to monitor the number and intensity of free-living STS transitions. A decline in lower-extremity functioning was defined as a drop of ≥2 points in the Short Physical Performance Battery (SPPB) from baseline to follow-up. Maximal isometric knee-extension strength was measured in the laboratory.

Results: 85 participants (75% women) declined in SPPB over 4 years. After adjusting for age, sex, and baseline SPPB points, higher free-living peak STS angular velocity (odds ratio [OR] = 0.70; 95% confidence interval [CI] = 0.52-0.92, per 20 deg/s increase) protected against a future decline. When adjusting the model for maximal isometric knee-extension strength, the statistical significance was attenuated (OR = 0.72; 95% CI = 0.54-0.96, per 20 deg/s increase).

Conclusions: Performing STS transitions at higher velocities in the free-living environment can prevent a future decline in lower-extremity function. This indicates that changes in daily STS behavior may be useful in the early identification of functional loss. Free-living peak STS angular velocity may be a factor underlying the longitudinal association of lower-extremity strength and performance.