In recent years, a number of research investigations have been conducted in an effort to determine whether declining balance and mobility among older adults can be reversed or at least slowed. Unfortunately, the results of a number of these studies have not yielded positive outcomes. Three reasons are forwarded to account for these unsuccessful outcomes: the lack of a contemporary theory-based approach to the problem, the failure to use multiple and diverse measures of balance and mobility, and the failure to design multidimensional interventions that target the actual source(s) of the balance or mobility-related impairments. A model fall-risk-reduction program designed to address each of the shortcomings associated with previous research findings is presented. The program is group based and suitable for implementation in community-based and residential care facilities.
Debra J. Rose
Despite the significant increase in years that an individual can now expect to live in the 21st century, there is growing evidence that the price for greater longevity may be worsening health due to the higher prevalence of nonfatal but disabling conditions. This sobering news suggests the need for expanded scientific inquiry directed at understanding the multilevel factors that promote or prevent physical activity (PA) participation and the adoption of healthy lifestyle behaviors and the types of intervention strategies that will be most effective in positively changing behavior at different life stages. Fruitful areas of future scientific inquiry include exploring other types and intensities of PA aimed at increasing PA participation while reducing sedentary behavior, better understanding the role of the physical and social environment in promoting PA participation, and designing and evaluating multilevel PA interventions that are better tailored to the activity preferences, goals, and expectations of a diverse older adult population, and flexibly delivered in real-world settings. Finally, conducting research aimed at better differentiating normal age-associated changes from those that are disease-related will be fundamental to reversing the negative stereotypes that currently shape the public’s view of the aging process.
Debra J. Rose
The discipline of kinesiology has the potential to make significant contributions to the study of fall-related disability and the advancement of national initiatives aimed at reducing disability in the older adult population. Theoretical frameworks routinely used to guide research across the subdisciplines of kinesiology could and should be applied to the study of fall-related disability and the development of movement-based interventions aimed at improving balance and gait and thereby reducing fall incidence rates and/or injury that contributes to premature morbidity and mortality. Current research findings suggest the need for a stronger focus on the learning or relearning of skilled movement patterns and/or cognitive strategies than currently exists in the falls intervention literature. As a profession, kinesiology is uniquely positioned to play an important role in advancing the goals of the Falls Free© national initiative given the important role that exercise plays in the reduction of fall-related disability and mortality.
Edited by Debra J. Rose and C. Jessie Jones
Susan Parks, Debra J. Rose, and John M. Dunn
This research studied the effects of cerebral palsy on the ability to plan and execute a one-handed aiming task. Simple reaction time (SRT) was fractionated into its premotor (PMT) and motor (MOT) components. Subjects were 20 youths, 10 with cerebral palsy and 10 nonhandicapped youths. The effect of accuracy demands on the planning and execution time was also studied by manipulating endpoint target size. Significant differences in PMT but not in MOT were obtained between groups, indicating that spastic hemiplegic cerebral palsied youths require more time to plan a simple aiming movement due to central processing limitations. Although manipulation of endpoint target size did not affect programming time for either group, the time to execute the movement increased significantly. This finding suggests that instead of incorporating the parameter of movement accuracy in the selected motor program, subjects adopted a feedback driven strategy to achieve greater endpoint accuracy.
Debra J. Rose, C. Jessie Jones, and Nicole Lucchese
The purpose of this study was to determine whether performance on the 8-ft up-and-go test (UG) could discriminate between older adult fallers (n = 71) and nonfallers (n = 63) and whether it would be as sensitive and specific a predictor of falls as the timed up-and-go test (TUG). Performance on the UG was significantly different between the recurrent faller and nonfaller groups (p < .01), as was performance on the TUG (p < .001). Older adults who required 8.5 s or longer to complete the UG were classified as fallers, with an overall prediction rate of 82%. The specificity of the test was 86% and the sensitivity was 78%. Conversely, the overall prediction rate for older adults who completed the TUG in 10 s or longer was 80%. The specificity of the TUG was 86% and the sensitivity was 71%.
Ehsan Sinaei, Debra J. Rose, Samira Javadpour, and Amin Kordi Yoosefinejad
Recently, a short form of the Fullerton Advanced Balance (SF-FAB) scale was reported as a good predictor of falls in older adults. However, we found no evidence regarding its reliability in non-American older adults. Therefore, we aimed to analyze the reliability and homogeneity of the SF-FAB scale to measure postural balance in Iranian older adults. Eighty-five community-dwelling older adults (70.75 ± 4.97 years) performed the SF-FAB test on two occasions 1 week apart. In both instances, four raters assessed the performance on the test. The SF-FAB scale (mean total score: 12.46 ± 3.53) revealed acceptable internal consistency (Cronbach’s α = .77), excellent intrarater reliability (intraclass correlation coefficient = .94–.99), and excellent interrater reliability (intraclass correlation coefficient = .92–.99). The overall prediction success rate was 83.5% with correctly classifying 95.6% of nonfallers and 35.3% of fallers. The SF-FAB scale can provide a quick screen of balance status in older adults to trigger referral to clinicians for a more comprehensive assessment.