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Ching-Yi Wang, Ching-Fan Sheu and Elizabeth Protas

The purpose of this study was to test the construct validity of the hierarchical levels of self-reported physical disability using health-related variables and physical-performance tests as criteria. The study participants were a community-based sample of 368 adults age 60 years or older. These older adults were grouped into 4 levels according to their physical-disability status (able, mildly disabled, moderately disabled, and severely disabled groups) based on their self-reported measures on the mobility, instrumented activity of daily living (IADL), and activities of daily living (ADL) domains. Health-related variables (body-mass index, number of comorbidities, depression status, mental status, and self-perceived health status) and eight performance-based tests demonstrated significant group differences. Self-reported measures of physical disability can be used to categorize older adults into different stages of physical functional decline.

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Ching-Yi Wang, Sharon L. Olson and Elizabeth J. Protas

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.

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Sharon L. Olson, Shu-Shi Chen and Ching-Yi Wang

Objective:

To determine exercise efficacy in improving dynamic balance in community-dwelling elderly with a fall history.

Methods:

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.

Results:

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.

Conclusions:

Excursion distances and directional control improved but not reaction time, suggesting that exercises requiring quick responses may be needed.

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Ching-Yi Wang, Ming-Hsia Hu, Hui-Ya Chen and Ren-Hau Li

To determine the test–retest reliability and criterion validity of self-reported function in mobility and instrumental activities of daily living (IADL) in older adults, a convenience sample of 70 subjects (72.9 ± 6.6 yr, 34 male) was split into able and disabled groups based on baseline assessment and into consistently able, consistently disabled, and inconsistent based on repeat assessments over 2 weeks. The criterion validities of the self-reported measures of mobility domain and IADL-physical subdomain were assessed with concurrent baseline measures of 4 mobility performances, and that of the self-reported measure of IADL-cognitive subdomain, with the Mini-Mental State Examination. Test–retest reliability was moderate for the mobility, IADL-physical, and IADL-cognitive subdomains (κ = .51–.66). Those who reported being able at baseline also performed better on physical- and cognitive-performance tests. Those with variable performance between test occasions tended to report inconsistently on repeat measures in mobility and IADL-cognitive, suggesting fluctuations in physical and cognitive performance.