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Cindy K. Piletic

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Roger Ramsbottom, Anne Ambler, Janie Potter, Barbara Jordan, Alan Nevill and Carol Williams

Where strength training has been used in conjunction with functional-task training in older people, not only have there been improvements in leg strength but also improved function has been measured (e.g., Skelton & McLaughlin, 1996). Many studies use participants from care homes rather than community dwellers. We investigated changes in leg power, balance, and functional mobility in community-dwelling sedentary men and women over 70 years of age (n = 6 for training group [TR]; n = 10 for control group [CN]). Progressive training took place over 24 weeks using seated and nonseated exercise. For TR, leg power increased 40%, from 108 ± 40 to 141 ± 53 W (p < .01); dynamic balance increased 48%, from 22.3 ± 7.9 to 33.1 ± 6.1 cm (p < .01; functional reach); and functional mobility increased 12%, from 7.46 ± 1.32 to 6.54 ± 1.41 s (p < .05; timed walk). CN showed no significant change. In conclusion, a community-based exercise program led to large improvements in leg-extensor power, dynamic balance, and functional mobility.

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Andrew E. Littmann, Masaki Iguchi, Sangeetha Madhavan, Jamie L. Kolarik and Richard K. Shields

Context:

There is conflicting evidence in the literature regarding whether women with anterior cruciate ligament reconstruction (ACLR) demonstrate impaired proprioception. This study examined dynamic-position-sense accuracy and central-nervous-system (CNS) processing time between those with and without long-term ACLR.

Objective:

To compare proprioception of knee movement in women with ACLR and healthy controls.

Design:

Cross-sectional.

Setting:

Human neuromuscular performance laboratory.

Participants:

11 women (age 22.64 ± 2.4 y) with ACLR (1.6–5.8 y postsurgery) and 20 women without (age 24.05 ± 1.4 y).

Interventions:

The authors evaluated subjects using 3 methods to assess position sense. During knee flexion at pseudorandomly selected speeds (40°, 60°, 80°, 90°, and 100°/s), subjects indicated with their index finger when their knee reached a predetermined target angle (50°). Accuracy was calculated as an error score. CNS processing time was computed using the time to detect movement and the minimum time of angle indication. Passive and active joint-position sense were also determined at a slow velocity (3°/s) from various knee-joint starting angles.

Main Outcome Measurements:

Absolute and constant error of target angle, indication accuracy, CNS processing time, and perceived function.

Results:

Both subject groups showed similar levels of error during dynamic-position-sense testing, despite continued differences in perceived knee function. Estimated CNS processing time was 260 ms for both groups. Joint-position sense during slow active or passive movement did not differ between cohorts.

Conclusions:

Control and ACLR subjects demonstrated similar dynamic, passive, and active joint-position-sense error and CNS processing speed even though ACLR subjects reported greater impairment of function. The impairment of proprioception is independent of post-ACLR perception of function.

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Tom Hazell, Kenji Kenno and Jennifer Jakobi

Aging leads to significant losses in muscle mass, strength, and the ability to independently perform activities of daily living (ADL). Typically, standard resistance training (RT) has been used to reduce these losses in function by maintaining or even increasing muscle strength in older adults. Increasing strength does not necessarily, however, result in an increase in the ability to perform ADL. There is now research suggesting that muscle power is more closely associated with the performance of ADL than muscle strength is, so training for muscle power might lead to more beneficial results in functional performance. This review of studies investigating the effect of training on ADL performance in older adults indicated that standard RT is effective in increasing strength in older adults, but power training that contains high-velocity contractions might be a more optimal means of training older adults when the emphasis is on increasing the performance of ADL.

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Jessica C. Dobek, Karen N. White and Katherine B. Gunter

The purpose of this study was to determine the degree to which a novel training program based on activities of daily living (ADL) would affect performance of ADLs, as well as the fitness of older adults. Fourteen individuals (mean age 82 years) took part in a 10-week control period followed by a 10-week ADL-based training program. Pre- and posttests included the Physical Performance Test (PPT), the Physical Functional Performance–10 (PFP-10), and the Senior Fitness Test (SFT). After the training period, improvements ranging from 7% to 33% (p < .05) were seen on the PPT and PFP-10 and on three items of the SFT. After conversion to standard scores, the magnitude of change in the PPT and the PFP-10 was significantly greater (p < .05) than the magnitude of change in the SFT. These data support the idea that this novel ADL-based training program was able to facilitate improved performance of ADLs, as well as select measures of fitness among older adults.

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Keith R. Johnston, Donna L. Goodwin and Jennifer Leo

Dignity, as an essential quality of being human, has been overlooked in exercise contexts. The aim of this interpretative phenomenological study was to understand the meaning of dignity and its importance to exercise participation. The experiences of 21 adults (11 women and 10 men) from 19 to 65 yr of age who experience disability, who attended a specialized community exercise facility, were gathered using the methods of focus-group and one-on-one interviews, visual images, and field notes. The thematic analysis revealed 4 themes: the comfort of feeling welcome, perceptions of otherness, negotiating public spaces, and lost autonomy. Dignity was subjectively understood and nurtured through the respect of others. Indignities occurred when enacted social and cultural norms brought dignity to consciousness through humiliation or removal of autonomy. The specialized exercise environment promoted self-worth and positive self-beliefs through shared life experiences and a norm of respect.

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Debra J. Rose

In recent years, a number of research investigations have been conducted in an effort to determine whether declining balance and mobility among older adults can be reversed or at least slowed. Unfortunately, the results of a number of these studies have not yielded positive outcomes. Three reasons are forwarded to account for these unsuccessful outcomes: the lack of a contemporary theory-based approach to the problem, the failure to use multiple and diverse measures of balance and mobility, and the failure to design multidimensional interventions that target the actual source(s) of the balance or mobility-related impairments. A model fall-risk-reduction program designed to address each of the shortcomings associated with previous research findings is presented. The program is group based and suitable for implementation in community-based and residential care facilities.

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Joanna S. Kostka, Jan W. Czernicki and Tomasz J. Kostka

We assessed the relative association of quadriceps muscle strength and power as well as optimal shortening velocity (υopt) to physical functioning in 28 women aged 50–87 years with chronic osteoarthritis participating in a three-week multimodal exercise program. Quadriceps muscle strength, power, υopt, and functional performance using the Activities of Daily Living (ADL) scale, Timed Up & Go (TUG) test, Tinetti test, and 6-Minute Walking Test (6-MWT) were assessed pre- and postrehabilitation. With rehabilitation, patients improved the values of strength, power, and the results of all functional tests. Both at baseline and postrehabilitation, functional status was more strongly related to power and υopt than to strength. Functional gains obtained with rehabilitation were not related to changes in power or υopt, and only very modestly related to changes in strength. Future studies should assess the benefits and feasibility of power- and velocity-oriented training in patients with osteoarthritis.

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Pai-Yun Cheng, Hsiao-Feng Chieh, Chien-Ju Lin, Hsiu-Yun Hsu, Jia-Jin J. Chen, Li-Chieh Kuo and Fong-Chin Su

a 40-second baseline period, the motor task containing 5 cycles of the force ramp task for each of the digits, alternated with a 30-second resting interval was completed. Outcomes Measures Finger independence The enslaving phenomenon is the unintentional force exerted from nontasked digits while the