The purpose of this study was to pilot test a function-focused exercise intervention consisting of strength and gait-speed training in elders with reduced walking speed, decreased walking endurance, and functional impairment. Twelve participants, 77.2 years old (± 7.34), whose usual gait speed was <0.85 m/s, with walking endurance of <305 m in 5 min, and who were functionally impaired participated in a moderate-intensity exercise intervention. The training occurred 3 times per week, 75 min per session, for 3 months and combined 4 weeks of gait-speed training, walking exercise, and functional strengthening. The participants demonstrated mean usual gait speeds (≥1.0 m/s), endurance (≥350 m), and functional ability (≥10 score on performance battery) that were within normal limits after 12 weeks of training. Fastest gait speed (≥1.5 m/s) and muscle strength also improved significantly. Improvements were maintained during follow-up testing after 3–6 months. In summary, a 12-week intervention for frail, mobility-disabled participants led to improvements in walking, function, and strength.
Elizabeth J. Protas and Sandrine Tissier
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.
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.
Mon S. Bryant, Diana H. Rintala, Jyh-Gong Hou, and Elizabeth J. Protas
To investigate the relationships between falls, fear of falling, and activity limitations in individuals with Parkinson’s disease (PD).
Cross-sectional study of individuals with mild to moderate PD (N = 83). Associations among demographic data, fall frequency, disease severity, motor impairment, ability to perform activities of daily living (ADL), Activities Balance Confidence Scale, Iowa Fatigue Scale, Comorbidity Index, and Physical Activity Scale for Elders were studied.
Frequent fallers had more ADL limitations than nonfallers (p < .001) and rare fallers (p = .004). Frequent fallers reported a lower percentage of ability to perform ADL than nonfallers (p = .003). Frequent fallers and rare fallers were less physically active than nonfallers (p = .015 and p = .040, respectively). Frequent fallers and rare fallers reported a higher level of fear of falling than nonfallers (p = .031 and p = .009, respectively).
Falls and fear of falling were associated with more ADL limitations and less physical activity after adjusting for physical impairments.