The purpose of this study was to assess the relative and absolute reliability of metabolic measures of energy expenditure and gait speed during overground walking in older adults with mobility limitations. Thirty-three (mean age [SD] = 76.4 [6.6] years; 66% female) older adults with slow gait participated. Measures of energy expenditure and gait speed were recorded during two 6-min bouts of overground walking (1 week apart) at a self-selected “usual” walking pace. The relative reliability for all variables was excellent: ICC = .81−.91. Mean differences for five of the six outcome variables was less than or equal to the respected SEM, while all six mean differences fell below the calculated MDC95. Clinicians and researchers can be confident that metabolic measures of energy expenditure and gait speed in older adults with slow walking speeds can be reliably assessed during overground walking, providing an alternative to traditional treadmill assessments.
David M. Wert, Jessie M. VanSwearingen, Subashan Perera and Jennifer S. Brach
Andrea L. Hergenroeder, Bethany Barone Gibbs, Mary P. Kotlarczyk, Subashan Perera, Robert J. Kowalsky and Jennifer S. Brach
The aim of this study was to evaluate accuracy of seven commercial activity monitors in measuring steps in older adults with varying walking abilities and to assess monitor acceptability and usability. Forty-three participants (age = 87 ± 5.7 years) completed a gait speed assessment, two walking trials while wearing the activity monitors, and questionnaires about usability features and activity monitor preferences. The Accusplit AX2710 Accelerometer Pedometer had the highest accuracy (93.68% ± 13.95%), whereas the Fitbit Charge had the lowest (39.12% ± 40.3%). Device accuracy varied based on assistive device use, and none of the monitors were accurate at gait speeds <0.08 m/s. Barriers to monitor usability included inability to apply monitor and access the step display. Monitor accuracy was rated as the most important feature, and ability to interface with a smart device was the least important feature. This study identified the limitations of the current commercial activity monitors in both step counting accuracy and usability features for older adults.
Joni S. Yates, Stephanie Studenski, Steven Gollub, Robert Whitman, Subashan Perera, Sue Min Lai and Pamela W. Duncan
This study evaluated the feasibility, safety, and findings from a protocol for exercise-bicycle ergometry in subacute-stroke survivors. Of 117 eligible candidates, 14 could not perform the test and 3 discontinued because of cardiac safety criteria. In the 100 completed tests, peak heart rate was 116 ± 19.1 beats/min; peak VO2 was 11.4 ± 3.7 ml · kg · min−1, peak METs were 3.3 ± 0.91, exercise duration was 5.1 ± 2.84 min., and Borg score was 14 ± 2.6. Among 71 tests, anaerobic threshold was achieved in 3.0 ± 1.7 min with a VO2 of 8.6 ± 1.7 ml · kg · min−1. After screening, this protocol is feasible and safe in subacute-stroke survivors with mild to moderate deficits. These stroke survivors have severely limited functional exercise capacity. Research and clinical practice in stroke rehabilitation should incorporate more comprehensive evaluation and treatment of endurance limitations.