Year: 2014
Type: letter
Abstract: With great interest, I read the article, “C-Reactive Protein, Vitamin D Deficiency, and Slow Gait Speed,” by Kositsawat, Barry, and Kuchel, in which the effect of vitamin D (25(OH)D) levels and those of C-reactive protein (CRP) on gait speed of people aged 50 and older was studied. The study found that low levels of 25(OH)D and high levels of CRP had an outcome of gait speeds less than 0.8 m/s. This suggests “that evaluation and correction of vitamin D levels may be especially important in individuals with high CRP levels.”1 I found this fascinating because, as a future physical therapy professional with a concentration in geriatrics, one of my future duties will be increasing gait speeds of elderly adults recuperating from falls and surgeries. This information is significantly relevant within the healthcare community. With increased use of evidence-based practice, it is important for clinicians to be current with the latest research in all areas of health care. Physical therapists who encourage adequate vitamin D intake can expect to see greater improvement with their treatments with regard to gait speed. Raising vitamin D levels to recommended concentrations may lead to an associated increase in an individual's trabecular bone strength, skeletal musculature, and gait speed. Studies have found that limitations on mobility are more likely to occur with inadequate vitamin D levels. Individuals who had 25(OH)D in concentrations lower than 75 nmol/L had an approximately 30% greater risk of developing limitations in mobility later in life, although individuals who had blood concentrations of vitamin D of less than 50 nmol/L were two times as likely as those with ample levels to develop limitations on mobility.2 By increasing intake of 25(OH)D, an individual's limitations may be reduced. Vitamin D levels have also been proven to have positive effects with regard to confidence in completing specific physical tasks. A study conducted in Amsterdam used 20 ng/mL as a cutoff for vitamin D concentrations in the blood. Participants were asked to answer questions related to activities of daily living. Those with levels below the cutoff were significantly more likely to report a limitation in at least one task than those with levels above the cutoff.3 Studies have also shown that adequate levels of 25(OH)D can contribute to maintenance of muscle strength in proximal areas of all extremities, which provides individuals with the confidence to perform activities of daily living. Clinicians can use this information to improve the overall health of their patients and to achieve better treatment outcomes. Limitations of this study include a small variation in testing methods. The only method used for measurement was a physical examination of the participant being timed walking 20 feet. Other possible tests could include the Timed Up and Go (TUG) test, which would test the individual's ability to stand up and walk, or the 6-minute walk test, which tests endurance. Another possible limitation could be the use of canes or walkers during the examination. Walkers and canes could hinder the observation of the potential benefits of adequate vitamin D in the diet by allowing the individual to rely on these devices for strength and stability. This research study could be expanded to determine which of the two important forms of vitamin D (ergocalciferol (vitamin D2) or cholecalciferol (vitamin D3)) has a stronger effect along with CRP on gait speeds. Future research could also include studies on the effects of other vitamins or micro- and macronutrients with regard to gait speed. This article provided information about how I could improve my future patients' treatments. It inspired me to look more closely at different areas of health care because many aspects play a critical role in the healing process. Along with observing the effects of physical treatment, clinicians need to be able to look past the mechanical approach and take into account the nutritional effects on one's performance. Conflict of Interest: The editor in chief has reviewed the conflict of interest checklist provided by the author and has determined that the author has no financial or any other kind of personal conflicts with this paper. Author Contributions: I am the sole author of this article. Sponsor's Role: None.
DOI: 10.1111/jgs.12831
Author: Daniel S. Kemp
Institution: Utica College
Language: English
Topic: Vitamin D Research Studies
Subfield: Pathology and Forensic Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2086194457