R. Barry Dale and Danny Myers
Edited by Monique Mokha
Wayne T. Phillips
Addie Middleton, George D. Fulk, Michael W. Beets, Troy M. Herter and Stacy L. Fritz
Daily ambulatory activity is associated with health and functional status in older adults; however, assessment requires multiple days of activity monitoring. The objective of this study was to determine the relative capabilities of self-selected walking speed (SSWS), maximal walking speed (MWS), and walking speed reserve (WSR) to provide insight into daily ambulatory activity (steps per day) in community-dwelling older adults. Sixty-seven older adults completed testing and activity monitoring (age 80.39 [6.73] years). SSWS (R 2 = .51), MWS (R 2 = .35), and WSR calculated as a ratio (R 2 = .06) were significant predictors of daily ambulatory activity in unadjusted linear regression. Cutpoints for participants achieving < 8,000 steps/day were identified for SSWS (≤ 0.97 m/s, 44.2% sensitivity, 95.7% specificity, 10.28 +LR, 0.58 −LR) and MWS (≤ 1.39 m/s, 60.5% sensitivity, 78.3% specificity, 2.79 +LR, 0.50 −LR). SSWS may be a feasible proxy for assessing and monitoring daily ambulatory activity in older adults.
Li-Tang Tsai, Merja Rantakokko, Anne Viljanen, Milla Saajanaho, Johanna Eronen, Taina Rantanen and Erja Portegijs
This cross-sectional study investigated associations between reasons to go outdoors and objectively-measured walking activity in various life-space areas among older people. During the study, 174 community-dwelling older people aged 75–90 from central Finland wore an accelerometer over seven days and recorded their reasons to go outdoors in an activity diary. The most common reasons for going outdoors were shopping, walking for exercise, social visits, and running errands. Activities done in multiple life-space areas contributed more to daily step counts than those done in the neighborhood or town and beyond. Those who went shopping or walked for exercise accumulated higher daily step counts than those who did not go outdoors for these reasons. These results show that shopping and walking for exercise are common reasons to go outdoors for community-dwelling older people and may facilitate walking activity in older age. Future studies on how individual trips contribute to the accumulation of steps are warranted.
George J. Holland, Kiyoji Tanaka, Ryosuke Shigematsu and Masaki Nakagaichi
This review examines the influences of physiological aging processes on connective tissue, joint integrity, flexibility (range of motion [ROM]), and physical functions of older adults. Studies that attempted to improve older adults' ROM are also critiqued. Multiple mechanisms of musculoskeletal and soft-tissue degeneration, as well as disease processes (osteoporosis, arthritis, atherosclerosis), contribute to significant decreases in neuromuscular function and ROM in older adults, all of which can be exacerbated by disuse influences. No delineation of disuse effects on the rate of aging-related decrements in ROM can be provided, however, because long-term investigations (with physical activity controls) have not been conducted. Research efforts have documented both upper and lower extremity decrements in ROM with development of physical impairments, reductions in basic and instrumental activities of daily living, and progression of disability. There is limited research evidence that either specialized stretch-training or general-exercise intervention protocols moderately improve ROM in older adults and the frail elderly.
Kyle Kiesel, Lee Burton and Gray Cook
Column-editor : Carl G. Mattacola
Anat V. Lubetzky, Bryan D. Hujsak, Gene Fu and Ken Perlin
Postural sway does not differentiate between balance disorders. Head kinematics within a salient, immersive environment could potentially help identifying movement patterns that are unique to vestibular dysfunction. We describe a virtual park scene, where participants are asked to avoid a virtual ball approaching their head, to target dynamic balance and quantify head movement strategy. Sixteen patients with vestibular dysfunction and 16 healthy controls were wearing the Oculus Rift and performed the “park” scene on floor and stability trainers. Significant between-group differences emerged in head path (patients rotated their head sideways more), head acceleration (controls had higher acceleration, especially on translation movements), and peak frequency (controls peaked around the frequency of the ball whereas patients were variable). Those findings demonstrated good to excellent test–retest reliability. There were no significant between-group differences in postural sway parameters. Future studies should establish norms across different levels of balance dysfunction and investigate the underlying mechanism leading to the movement strategy observed.
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%.
Thomas M. Maden-Wilkinson, Jamie S. McPhee, David A. Jones and Hans Degens
To investigate reasons for the age-related reduction in physical function, we determined the relationships between muscle size, strength, and power with 6-min walk distance (6MWD) and timed up-and-go performance in 49 young (23 ± 3.1 years) and 66 healthy, mobile older adults (72 ± 5 years). While muscle mass, determined by DXA and MRI, did not correlate with performance in the older adults, power per body mass, determined from a countermovement jump, did correlate. The 40% lower jumping power observed in older adults (p < .05) was due to a lower take-off velocity, which explained 34% and 42% of the variance in 6MWD in older women and men, respectively (p < .01). The lower velocity was partly attributable to the higher body mass to maximal force ratio, but most was due to a lower intrinsic muscle speed. While changes in muscle function explain part of the age-related reduction in functional performance, ~60% of the deficit remains to be explained.
Simona Bar-Haim, Ronit Aviram, Anat Shkedy Rabani, Akram Amro, Ibtisam Nammourah, Muhammed Al-Jarrah, Yoav Raanan, Jack A. Loeppky and Netta Harries
and motor function in adolescents and young adults with CP, and then measure and correlate the changes in HPA and motor function induced by exercise interventions in the same population. Mobility measures and 4-day averages of HPA by accelerometer were obtained before (T1) and after (T2) 4-month