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Prescribing the correct exercise program is a challenge for older adults with multiple physiological impairments. The authors evaluated an assessment instrument that incorporates results of multiple categories of impairment, including strength, balance, gait, vision, and cognitive function. The physical therapist made judgments on the relative impact of 9 different impairments on specific exercises and on the total impact of all impairments on particular exercises. In a cohort age 75–85 y, functional limitations, impaired balance, pain, and low physical endurance were estimated to have the largest impact on the ability to carry out exercise activities, primarily walking, stair climbing, balance exercises, and stationary bicycling. The assessments revealed that the ability to exercise was related to objective measures of function, indicating that the therapist incorporated such objective measures into the impairment-impact rating. The impairment-impact assessment facilitates creating individualized exercise prescriptions for individuals with impairments.
Hirvensalo is with the Dept. of Sport Sciences, University of Jyväskylä, Jyväskylä, 40014 Finland. Cohen-Mansfield is with the Hebrew Home of Greater Washington, Research Institute on Aging, Rockville, MD 20825. Rind is with the Outpatient Center, Adventist Rehabilitation Hospital, Silver Spring, MD 20903. Guralnik and Hirvensalo are with the National Institute of Aging, National Institute of Health, Bethesda, MD 20892.