The purposes of this study were to evaluate community-dwelling elderly adults with different levels of perceived mobility with 5 physical-performance tests, determine the cutoff values of the 5 tests, and identify the best tests for classifying mobility status. The community-mobility statuses of 203 community-dwelling elders were classified as able, decreased, or disabled based on their self-reported ability to walk several blocks and climb stairs. They also performed the functional reach, timed 50-ft walk, timed 5-step, timed floor transfer, and 5-min-walk endurance tests. We found in all tests that the “able” outperformed the “decreased” and that the “decreased” outperformed the “disabled,” except on the floor-transfer task. The optimum cutoff values of the 5 performance tests were also reported. The 5-min walk and timed 5-step test could best separate the “able” from the “decreased,” whereas the 50-ft-walk-test could best differentiate the “decreased” from the “disabled.” The results suggest that community-mobility function of older adults can be captured by performance tests and that the cutoff values of the 5-min-walk, 5-step, and 50-ft-walk tests can be used in guiding intervention or prevention programs.
Ching-Yi Wang, Sharon L. Olson and Elizabeth J. Protas
Sharon L. Olson, Shu-Shi Chen and Ching-Yi Wang
To determine exercise efficacy in improving dynamic balance in community-dwelling elderly with a fall history.
Thirty-five participants were randomly assigned to a treatment (TG; n = 19, 77 ± 7 yr) or control group (CG; n = 16, 75 ± 8 yr). The TG received an individualized home exercise program, and the CG received phone calls twice per week for 12 weeks. Participants’ dynamic-balance abilities— directional control (DC), endpoint excursion (EE), maximum excursion (ME), reaction time (RT), and movement velocity (MV)—were measured using the Balance Master at 75% limits of stability. Functional reach (FR) was also measured.
At 12 weeks the TG demonstrated significant improvements in DC (p < .0025), EE (p < .0005), and ME (p < .0005), but the CG did not. No significant group differences were found for MV, RT, or FR.
Excursion distances and directional control improved but not reaction time, suggesting that exercises requiring quick responses may be needed.
Mary A. Murphy, Sharon L. Olson, Elizabeth J. Protas and Averell R. Overby
Fifty community-dwelling elders were screened and followed for 14 months. Sixteen experienced falls and 34 did not. The screening variables consisted of age, the Clinical Test of Sensory Interaction in Balance, the Performance-Oriented Mobility Assessment for Balance, functional reach, the Physical Performance Test, and the following timed tests: floor transfer; 5-step test; 5 chair stands; tandem, semitandem, and side-by-side stance; penny pick-up; 360° turn; 50-ft walk; and 5-min walk. Data analysis and chi-squared or t tests were performed for each variable to determine significant differences between groups. Correlations, sensitivity, and specificity were calculated, and a stepwise discriminant analysis was conducted to determine which significant variables best predicted falls. Discriminant analysis determined that the floor transfer and then the 50-ft walk predicted falls in community-dwelling elders, correctly classifying 95.5% of participants. Prediction for falls was 81.8%, and for no falls, 100%. The timed floor transfer and 50-ft walk were the most discriminating measures to identify potential fallers.