Diminished Dynamic Physical Performance Is Associated With Orthostatic Hypotension in Geriatric Outpatients

Eline S de Bruïne; Esmee M Reijnierse; Marijke C Trappenburg; Jantsje H Pasma; Oscar J de Vries; Carel G M Meskers; Andrea B Maier

doi:10.1519/JPT.0000000000000186

Diminished Dynamic Physical Performance Is Associated With Orthostatic Hypotension in Geriatric Outpatients

Eline S de Bruïne
, Esmee M Reijnierse
, Marijke C Trappenburg
, Jantsje H Pasma
, Oscar J de Vries
, Carel G M Meskers
, Andrea B Maier

Biomechanics

Research output: Contribution to Journal › Article › Academic › peer-review

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Abstract

BACKGROUND AND PURPOSE: Orthostatic hypotension (OH), a blood pressure drop after postural change, is a highly prevalent and disabling syndrome in older adults. Yet, the association between physical performance and OH is not clearly established. The aim of this study was to determine whether different types of physical performance are associated with OH in a clinically relevant population of geriatric outpatients.

METHODS: This cross-sectional study included 280 geriatric outpatients (mean age: 82.2 years, standard deviation: 7.1). Orthostatic hypotension was determined using intermittently measured blood pressure and continuously measured blood pressure in a random subgroup of 58 patients. Physical performance was classified into a dynamic type (4-m Walk Test, Chair Stand Test, and Timed Up and Go test) and a static type (standing balance tests, handgrip strength). Associations were analyzed using logistic regression models with adjustments for age, sex, weight, and height.

RESULTS: Diminished physical performance on the Chair Stand Test was associated with OH measured intermittently. Diminished physical performance on all dynamic physical domains (4-m Walk Test, Chair Stand Test, and Timed Up and Go test) was associated with OH measured continuously. Static physical performance was not significantly associated with OH.

CONCLUSION: Dynamic physical performance tests with a substantial postural change and center of mass displacement were significantly associated with OH. The influence of physical performance on OH in daily routine activities should be further explored to establish counteracting interventions.

Original language	English
Pages (from-to)	e28-e34
Number of pages	7
Journal	Journal of Geriatric Physical Therapy
Volume	42
Issue number	3
Early online date	23 Mar 2018
DOIs	https://doi.org/10.1519/JPT.0000000000000186
Publication status	Published - Jul 2019

Funding

1Department of Internal Medicine, Section of Gerontology and Geriatrics, VU University Medical Center Amsterdam, Amsterdam, the Netherlands. 2Department of Geriatrics, Westfriesgasthuis, Hoorn, the Netherlands. 3Department of Internal Medicine, Amstelland Hospital, Amstelveen, the Netherlands. 4Department of Biomechanical Engineering, Delft University of Technology, Delft, the Netherlands. 5Department of Internal Medicine, OLVG Hospital, Amsterdam, the Netherlands. 6Department of Rehabilitation Medicine, VU University Medical Center Amsterdam, Amsterdam, the Netherlands. 7Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, the Netherlands. 8Department of Medicine and Aged Care, Royal Melbourne Hospital, The University of Melbourne, Melbourne, Australia. The authors have declared that no competing interests exist. This study was supported by the Dutch Technology Foundation STW, which is part of the Netherlands Organisation for Scientific Research (NWO) and which is partly funded by the Ministry of Economic Affairs. Furthermore, this study was supported by the seventh frame-work program MYOAGE (HEALTH-2007-2.4.5-10), 050-060-810 Netherlands Consortium for Healthy Aging (NCHA), the European Union’s Horizon 2020 research program PreventIT (No 689238) and the Marie Curie, Sklodowska, Innovative Training Network PANINI (No 675003). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The authors declare no conflicts of interest. Address correspondence to: Andrea B. Maier, MD, PhD, Department of Medicine and Aged Care, Royal Melbourne Hospital, The University of Melbourne, Grattan St, Parkville Victoria 3052, Australia ([email protected]). Richard Bohannon was the Decision Editor. Copyright © 2018 Academy of Geriatric Physical Therapy, APTA The authors have declared that no competing interests exist. This study was supported by the Dutch Technology Foundation STW, which is part of the Netherlands Organisation for Scientific Research (NWO) and which is partly funded by the Ministry of Economic Affairs. Furthermore, this study was supported by the seventh framework program MYOAGE (HEALTH-2007-2.4.5-10), 050- 060-810 Netherlands Consortium for Healthy Aging (NCHA), the European Union's Horizon 2020 research program PreventIT (No 689238) and the Marie Curie, Sklodowska, Innovative Training Network PANINI (No 675003).

Funders	Funder number
Dutch Technology
European Union's Horizon 2020 research program PreventIT
European Union’s Horizon 2020 research program PreventIT	689238
Foundation STW
NCHA
Marie Curie	675003
Nederlandse Organisatie voor Wetenschappelijk Onderzoek
Stichting voor de Technische Wetenschappen
Ministry of Economic Affairs
seventh frame-work program MYOAGE	HEALTH-2007-2.4.5-10
seventh framework program MYOAGE

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title = "Diminished Dynamic Physical Performance Is Associated With Orthostatic Hypotension in Geriatric Outpatients",

abstract = "BACKGROUND AND PURPOSE: Orthostatic hypotension (OH), a blood pressure drop after postural change, is a highly prevalent and disabling syndrome in older adults. Yet, the association between physical performance and OH is not clearly established. The aim of this study was to determine whether different types of physical performance are associated with OH in a clinically relevant population of geriatric outpatients.METHODS: This cross-sectional study included 280 geriatric outpatients (mean age: 82.2 years, standard deviation: 7.1). Orthostatic hypotension was determined using intermittently measured blood pressure and continuously measured blood pressure in a random subgroup of 58 patients. Physical performance was classified into a dynamic type (4-m Walk Test, Chair Stand Test, and Timed Up and Go test) and a static type (standing balance tests, handgrip strength). Associations were analyzed using logistic regression models with adjustments for age, sex, weight, and height.RESULTS: Diminished physical performance on the Chair Stand Test was associated with OH measured intermittently. Diminished physical performance on all dynamic physical domains (4-m Walk Test, Chair Stand Test, and Timed Up and Go test) was associated with OH measured continuously. Static physical performance was not significantly associated with OH.CONCLUSION: Dynamic physical performance tests with a substantial postural change and center of mass displacement were significantly associated with OH. The influence of physical performance on OH in daily routine activities should be further explored to establish counteracting interventions.",

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AU - Pasma, Jantsje H

AU - de Vries, Oscar J

AU - Meskers, Carel G M

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Diminished Dynamic Physical Performance Is Associated With Orthostatic Hypotension in Geriatric Outpatients

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