Relationship between Vascular Function and Lower Extremity Muscle Strength in Elderly Health Care Facility Patients with Near Average Life Expectancy

Background: Decreased standing ability, including standing up and sitting down, is one of the factors that negatively affect pulse wave velocity (baPWV) in elderly women. Objective: The purpose of this study was to determine the relationship between lower limb muscle strength, movement ability, and pulse wave velocity in suburban Japanese elderly people living in a typical nursing home for the elderly. Subjects and Methods: Subjects were a group of elderly people who were able to walk independently and who were residing in three long-term care health care facilities in Gunma Prefecture. The cross-sectional study period was from April 2016 to March 2018. Outcomes were BMI values, body fat percentage (%), total body muscle mass (kg), and brachial-ankle pulse wave velocity (baPWV). Performance test measures were: duration of 5 rise tests and number of 30-second repetition heel lift repetition tests. Statistical analysis was performed to assess descriptive statistics and the frequency of people falling into the standard range for each outcome, and multiple regression analysis was performed. Results: Forty-nine participants and 32 participants were included in the analysis. baPWV values were 2089.8±623.3 in Facility A, 1961.5±353.0 in Facility B, and 2203.5±773.9 in Facility C. There was no difference between the facilities. The low BMI group had significantly higher baPWV than the normal BMI group (p=0.010). baPWV was significantly higher in the group that was able to perform 20 or more heel lifts than in the group that performed 19 or fewer (p=0.035). Conclusion: BMI was found to be related to vascular function independently of exercise function. In elderly patients with near-average life expectancy, physical therapy aimed at maintaining lower extremity muscle strength, as distinguished from the improvement of motor ability, is considered important to the extent possible.