Search Results

You are looking at 111 - 120 of 533 items for :

  • "community-dwelling" x
Clear All
Restricted access

Catrine Tudor-Locke, Tiago V. Barreira, Robert M. Brouillette, Heather C. Foil and Jeffrey N. Keller

Background:

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.

Methods:

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.

Results:

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.

Conclusions:

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.

Restricted access

Kim T.J. Bongers, Yvonne Schoon, Maartje J. Graauwmans, Marlies E. Hoogsteen-Ossewaarde and Marcel G.M. Olde Rikkert

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.

Restricted access

Robert M. Kaplan, Alison K. Herrmann, James T. Morrison, Laura F. DeFina and James R. Morrow Jr.

Background:

Despite benefits of physical activity (PA), exercise is also associated with risks. Musculoskeletal injury (MSI) risk increases with exercise frequency/intensity. MSI is associated with costs including medical care and time lost from work.

Purpose:

To evaluate the economic costs associated with PA-related MSIs in community-dwelling women.

Method:

Participants included 909 women in the Women’s Injury Study reporting PA behaviors and MSI incidence weekly via the Internet for up to 3 years (mean follow-up 1.89 years). Participants provided consent to obtain health records. Costs were estimated by medical records and self-reports of medical care. Components included physician visits, medical facility contacts, medication costs, and missed work.

Results:

Of 909 participants, 243 reported 323 episodes of expenditure or contact with the health care system associated with PA. Total costs of episodes ranged from $0–$18,934. Modal cost was $0 (mean = $433 ± $1670). Costs were positively skewed with nearly all participants reporting no or very low costs.

Conclusions:

About 1 in 4 community-dwelling women who are physically active experienced a PA-related MSI. The majority of injuries were minor, and large expenses associated with MSI were rare. The long-term health benefits and costs savings resulting from PA likely outweigh the minor costs associated with MSI from a physically-active lifestyle.

Restricted access

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.

Restricted access

Tamar Semerjian and Dawn Stephens

This study examined the relationships between older women’s comparison styles, physical self-perceptions, and functional fitness. Participants were community-dwelling women (N = 102, age 65-99) living in the mid-Atlantic region of the United States. Individuals were categorized as relying primarily on social comparisons, temporal comparisons, or a combination of both styles. Also of interest was whether individuals evaluated themselves positively or negatively when making comparisons. Participants who evaluated themselves positively as compared with others were found to have higher levels of physical self-perception. Analyses revealed that women who relied primarily on temporal comparisons had higher self-perceptions of their functional ability than those who relied on a combination of comparison styles. An avoidance of both temporal and social comparisons was also related to higher levels of physical self-perception.

Restricted access

Simone Nicolai, Petra Benzinger, Dawn A. Skelton, Kamiar Aminian, Clemens Becker and Ulrich Lindemann

The purpose of the study was to investigate whether a 24-hr recording period is sufficient to describe physical activity (PA) of 1 week for intraindividual comparison in older adults. Furthermore, the authors analyzed whether physical performance can be used as a surrogate marker of PA. PA was captured on 7 consecutive days by a body-fixed sensor in 44 community-dwelling older adults (80.75 ± 4.05 yr). Mean times of walking and of “time on feet” of the group were 10.2 hr (± 3.5) and 35.1 hr (± 9.43), respectively. Intraindividual variabilities of walking and of time on feet were 31.9% ± 10.79% and 19.4% ± 8.76%, respectively. Accumulated time of variables of PA showed no differences between weekdays, with variabilities of 3.8% and 1.8% for walking and time on feet, respectively. Association between Short Physical Performance Battery and PA was limited (walking r = .397, time on feet r = .41).

Restricted access

Ronald D. Adelman, Michele G. Greene, Erika Friedmann, Marcia G. Ory and Caitlin E. Snow

This cross-sectional observational study examined the frequency of older patient–physician discussions about exercise, who initiates discussions, and the quality of questioning, informing, and support about exercise. The study used a convenience sample of 396 follow-up visits at 3 community-based practice sites, with 376 community-dwelling older patients and 43 primary-care physicians. Audiotapes were analyzed using the Multi-Dimensional Interaction Analysis coding system. Results demonstrate that exercise was discussed in 13% of visits and the subject was raised equally by patients and physicians. Exercise was significantly more likely to be discussed in dyadic visits (14.7%) than in triadic visits (4.1%). Patient level of education, patient overall physical health, and the physician’s being female were significant predictors of the occurrence of exercise discussion. Given the importance of exercise for maintaining health and independence in older adults, more clinical and research attention is needed to address barriers to effective discussions in this area.

Restricted access

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.

Restricted access

L. Jerome Brandon, Lisa W. Boyette, Adreinne Lloyd and Deborah A. Gaasch

The purpose of this study was to evaluate the effects of a 24-month moderate-intensity resistive-training intervention on strength and function in older adults. A repeated-measures experimental research design was employed as a sample of 55 apparently healthy, older, community-dwelling volunteers (30 exercisers—25 women and 5 men; 25 comparisons—16 women and 9 men) were evaluated for strength of 5 muscle groups that influence lower extremity movement and physical function. Strength and function were evaluated at 6-month intervals. The findings from this study indicate that a moderate-intensity resistive-training program increases strength in older adults and that the strength benefits are retained for the duration of the intervention. Furthermore, a long-term strength-training program can increase independent-function skills in older adults and might therefore aid in prolonging functional independence.

Restricted access

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.