Self-management of mobility and fall risk might be possible if older adults could use a simple and safe self-test to measure their own mobility, balance, and fall risk at home. The aim of this study was to determine the safety, feasibility, and intraindividual reliability of the maximal step length (MSL), gait speed (GS), and chair test (CT) as potential self-tests for assessing mobility and fall risk. Fifty-six community-dwelling older adults performed MSL, GS, and CT at home once a week during a four-week period, wherein the feasibility, test-retest reliability, coefficients of variation, and linear mixed models with random effects of these three self-tests were determined. Forty-nine subjects (mean age 76.1 years [SD: 4.0], 19 females [42%]) completed the study without adverse effects. Compared with the other self-tests, MSL gave the most often (77.6%) valid measurement results and had the best intraclass correlation coefficients (0.95 [95% confidence interval: 0.91−0.97]). MSL and GS gave no significant training effect, whereas CT did show a significant training effect (p < .01). Community-dwelling older adults can perform MSL safely, correctly, and reliably, and GS safely and reliably. Further research is needed to study the responsiveness and beneficial effects of these self-tests on self-management of mobility and fall risk.
Kim T.J. Bongers, Yvonne Schoon, Maartje J. Graauwmans, Marlies E. Hoogsteen-Ossewaarde and Marcel G.M. Olde Rikkert
Stephen M. Haley, Larry H. Ludlow and Jill T. Kooyoomjian
As a preliminary step in developing the physical-functioning measure of the Late-Life Function and Disability Instrument (LLFDI), the authors compared its items with the physical-functioning items (PF-10) on the SF-36 Health Survey. They compared the item coverage, hierarchy, and scale-separation properties of the PF-10 items with those of the physical-functioning items of the LLFDI. Both questionnaires were administered to 50 community-dwelling older adults. A partial-credit, 1-parameter, item-response-theory model was used to scale the items. The LLFDI improved the range of ability of daily activities that was encompassed by the PF-10 items by 46%. By sequentially deleting new items with poor fit to the overall scale and items with redundant content, the authors developed a scale more capable of accurately assessing low-functioning activities. The LLFDI function component incorporates a broader content range and better person and item separation than the PF-10 items. It appears to have potential as a comprehensive functional-activity assessment for community-dwelling older adults.
Catrine Tudor-Locke, Tiago V. Barreira, Robert M. Brouillette, Heather C. Foil and Jeffrey N. Keller
The relationship between clinically assessed and free-living walking is unclear. Cadence (steps/min) can be measured accurately under both conditions using modern technologies, thus providing a common measurement metric. Therefore, the purpose of this study was to compare clinical and free-living cadence in older adults.
15 community-dwelling older adults (7 men, 8 women; 61–81 years) completed GAITRite-determined normal and dual-task walks and wore objective monitors for 1 week. Descriptive data included gait speed (cm/sec), steps/day, as well as cadence. Nonparametric tests evaluated differences between normal and dual-task walks and between accelerometer- and pedometer-determined steps/day. Free-living time detected above clinically determined cadence was calculated.
Participants crossed the GAITRite at 125.56 ± 15.51 cm/sec (men) and 107.93 ± 9.41 steps/min (women) during their normal walk and at 112.59 ± 17.90 cm/sec and 103.10 ± 1.30 steps/min during their dual-task walk (differences between walks P < .05). Overall, they averaged 7159 ± 2480 (accelerometer) and 7813 ± 2919 steps/day (pedometer; difference NS). On average, < 10 min/day was spent above clinically determined cadences.
High-functioning, community-dwelling older adults are capable of walking at relatively high cadences (ie, > 100 steps/min). However, the same behavior appears to be uncommon in daily life, even for a minute.
Jakob L. Vingren, James R. Morrow Jr., Elaine Trudelle-Jackson and Merly T. Mathew
Aerobic and muscle-strengthening activities are related to morbidities and mortality. Resistance exercise/strength training items are included in national surveys, but the manner in which muscle-strengthening activity is queried varies among these surveys.
The purpose of this study was to use different self-report measures to examine the prevalence of meeting the 2008 Physical Activity Guidelines for Americans regarding muscle-strengthening activities among women.
We surveyed 606 community-dwelling women at 4 points in time across a 1.5- to 3-year time period to determine whether the respondents met the national physical activity guidelines for performing muscle-strengthening activities ≥ 2 days per week.
Results were consistent across time but depended on the manner in which the question was asked. If asked to reflect over the past month or a general question about the typical number of days engaged, approximately 40% of women reported engaging in ≥ 2 days per week of resistance exercise/strength training. However, when reports were obtained weekly for 13 weeks, only approximately 18% of respondents met the guidelines.
Results indicate that the timing and nature of questioning can substantially influence the self-reported prevalence of muscle-strengthening physical activities for community-dwelling women.
David Alexander Leaf and Holden MacRae
The purpose of this study was to examine the criterion-related validity of two indirect measures of energy expenditure (EE): American College of Sports Medicine (ACSM) predictive equations, and estimated EE based on the Caltrac accelerometer. These measures were compared in 20 community-dwelling older men and women (mean age 71 years). The strength of the relationships among major determinants of EE during self-selected speeds of treadmill and outdoor walking was also examined. EE measured by respiratory gas analysis during an exercise stress test was highly correlated with ACSM predictive equations and poorly correlated with Caltrac. Multivariate regression equations were established to evaluate the ability of independent variables—body weight and height, age, and preferred treadmill walking speed—to predict EE (dependent variable). It was concluded that the ACSM predictive equations are suitable for use in elderly individuals, and that the apparent differences in the relationships between treadmill and outdoor walking speeds on EE deserve further investigation.
Kenneth E. Mobily and Paula R. Mobily
The primary purpose of this investigation was to determine the internal consistency of the 60+ functional fitness test battery for older adults. A secondary purpose was to determine whether the number of trials recommended in the testing manual was optimal. Subjects were used from an ongoing study of a fitness program for community-dwelling older adults. Internal consistency coefficients for subtests of flexibility, agility, coordination, and strength were excellent. Post hoc analysis across trials indicated significant differences in means between early trials and later trials. Mean scores stabilized after two or three trials, depending on the subtest of interest. Data provided insight into the number of practice trials and amount of warm-up necessary to implement the 60+ functional fitness test battery in field settings.
Koen A.P.M. Lemmink, Han C.G. Kemper, Mathieu H.G. de Greef, Piet Rispens and Martin Stevens
This article focuses on the validity of the circumduction test for measuring shoulder flexibility in older adults. Participants included 137 community-dwelling older adults. Equipment consisted of a cord with a fixed handle on one end and a sliding handle on the other. The sliding handle was adjusted so that the cord length between the 2 handles equaled the participant’s shoulder width. Holding the 2 handles, the participant must pass the cord from the front of the body over the head and as far back as possible with extended arms. The score is the fanning-out angle. Forward flexion, abduction, horizontal retroflexion, and outward rotation were also measured. The test and criterion measurements were administered within 1 wk. The criterion-related validity of the circumduction test as a measure of forward flexion and horizontal retroflexion received support from moderate correlations. Its use as a measure of abduction and outward rotation, however, received no support from the data.
Christine B. Phillips, Jerri D. Edwards, Ross Andel and Marcus Kilpatrick
Physical activity (PA) is believed to preserve cognitive function in older adulthood, though little is known about these relationships within the context of daily life. The present microlongitudinal pilot study explored within- and between-person relationships between daily PA and cognitive function and also examined within-person effect sizes in a sample of community-dwelling older adults. Fifty-one healthy participants (mean age = 70.1 years) wore an accelerometer and completed a cognitive assessment battery for five days. There were no significant associations between cognitive task performance and participants’ daily or average PA over the study period. Effect size estimates indicated that PA explained 0–24% of within-person variability in cognitive function, depending on cognitive task and PA dose. Results indicate that PA may have near-term cognitive effects and should be explored as a possible strategy to enhance older adults’ ability to perform cognitively complex activities within the context of daily living.
Michelle Y. Martin, M. Paige Powell, Claire Peel, Sha Zhu and Richard Allman
This study examined whether leisure-time physical activity (LTPA) was associated with health-care utilization in a racially diverse sample of rural and urban older adults. Community-dwelling adults (N = 1,000, 75.32 ± 6.72 years old) self-reported participating in LTPA and their use of the health-care system (physician visits, number and length of hospitalizations, and emergency-room visits). After controlling for variables associated with health and health-care utilization, older adults who reported lower levels of LTPA also reported a greater number of nights in the hospital in the preceding year. There was no support, however, for a relationship between LTPA and the other indicators of health-care utilization. Our findings suggest that being physically active might translate to a quicker recovery for older adults who are hospitalized. Being physically active might not only have health benefits for older persons but also lead to lower health-care costs.
Kristin Musselman and Brenda Brouwer
This study examined gender differences in balance, gait, and muscle performance in seniors and identified gender-specific factors contributing to physical performance. Forty (20 men, 20 women) healthy, community-dwelling seniors (74.5 ± 5.3 years) participated. Limits of stability, gait speed, lower limb flexor and extensor isokinetic concentric peak torques, self-reported activity level, and balance confidence were measured. No gender differences were detected in gait speed, limits of stability when normalized to height, activity level, or balance confidence (p ≥ .188). Women were weaker than men (p ≤ .007), even after controlling for weight and body-mass index, suggesting that other gender-related factors contribute to strength. Gender accounted for 18–46% of the variance in strength and served as a modifier of the relationship between activity level and strength in some muscle groups. The primary factors relating to gender-specific strength was activity level in men and body weight in women.