Mobility, the ability to move independently, is critical to maintaining independence and quality of life. Among older adults, mobility disability results when an individual cannot meet the demands of the environment. Current approaches to defining mobility rely on distance and time measures, or decompose mobility into subtasks (e.g., climbing, sit to stand), but provide limited understanding of mobility in the elderly. In this paper, a new conceptual framework identifies the critical environmental factors, or dimensions, that operationally define mobility within a given community, such as ambient conditions (light levels, weather conditions) and terrain characteristics (stairs, curbs). Our premise is that the environment and the individual conjointly determine mobility disability. Mobility in the elderly is defined not by the number of tasks a person can or cannot perform, but by the range of environmental contexts in which tasks can be safely carried out: the more disabled, the more restrictive the dimensions.
Aftab E. Patla and Anne Shumway-Cook
Richard Larouche, Joel D. Barnes, Sébastien Blanchette, Guy Faulkner, Negin A. Riazi, François Trudeau and Mark S. Tremblay
living too far from their school for AT to be a feasible option ( 25 , 50 ). Recent studies also suggest that promoting children’s independent mobility (IM; ie, children’s freedom to move around in public space without adult supervision) might be a promising strategy to increase both AT and PA among
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.
Gareth R. Jones, Jennifer M. Jakobi, Albert W. Taylor, Rob J. Petrella and Anthony A. Vandervoort
Community-based rehabilitative exercise programs might be an effective means to improve functional outcomes for hip-fracture patients. The purpose of this study was to evaluate the effectiveness of a community exercise program (CEP) for older adults recovering from hip fracture. Twenty-five older adults (mean age 80.0 ± 6.0 years; 24 women; 71 ± 23 days post–hip fracture) participated in this pilot study (17 exercise, 8 control). The CEP involved functional stepping and lower extremity–strengthening exercises. Control participants received only standard outpatient therapy. Measures of functional mobility, balance confidence, falls efficacy, lower extremity strength, and daily physical activity were evaluated at baseline and at 16 weeks. Improvements for self-reported physical activity, mobility, balance, and knee-extensor strength were observed for the CEP group. This study demonstrated that a CEP is beneficial for community-dwelling older adults post–hip fracture.
Thomas G. Palmer, D, Bradley Wilson, Mallory Kohn and Sarah Miko
The Graston technique (GT) is prescribed to increase range of motion (ROM) in pathological patients, however little evidence exists regarding the effect GT has on healthy soft tissue joint ROM. The purpose of this study was to evaluate the effect GT would have on ankle dorsifl xion when compared with traditional static stretching (TS) among 50 healthy track and field volunteers. Participants were randomly assigned to a GT, TS, or control group. GT yielded a greater increase in talocrural joint dorsifl xion when compared with TS. GT seems to provide mobility to healthy tissue, such as fascia and muscle not previously reported.
Jaclyn Megan Sions, Elisa Sarah Arch and John Robert Horne
. There has been less focus on modifiable factors that may predict physical activity, such as reduced functional mobility, suboptimal balance confidence, and lack of prosthetic use. Identifying modifiable factors that influence physical activity is critical to reduce morbidity and mortality for adults
Rienk M.A. van der Slikke, Annemarie M.H. de Witte, Monique A.M. Berger, Daan J.J. Bregman and Dirk Jan H.E.J. Veeger
In wheelchair sports, athlete and wheelchair form one functional unit determining individual wheelchair mobility performance (WMP). 1 To enhance the performance, athletes could focus on physical progress, technical wheelchair improvement, or optimization of the interaction between both. That
Linda C. Campanelli
Functional mobility is generally considered a major contributor to maintaining quality of life at any age. There are several overviews of physiological aging relative to physical functioning and/or mobility in the recent literature. This paper reiterates the need for continued exercise (at all levels) throughout one’s lifetime, specifically to enhance quality of life and functional independence. Implications for professionals and program development are included. Tailored exercises for both ambulatory and nonambulatory older adults to maintain flexibility, gait, and bed mobility are described.
Anna Mulasso, Mattia Roppolo, Monica Emma Liubicich, Michele Settanni and Emanuela Rabaglietti
The aim of this study was to assess the direct and indirect effects of a multicomponent exercise (MCE) program on mobility and balance in institutionalized older people. One hundred and twelve subjects (85 women; 83.0 years on average; SD = 7.5) were included in the study, and divided into a MCE-group (MCE-G) and a control group (CG) according to matching techniques. The MCE-G consisted of a 9-month program featuring range-of-motion, strength, and balance exercises performed in small groups. The CG received routine medical and nursing care. The timed up-and-go test and Tinetti Performance-Oriented Mobility Assessment balance subscale were administered at baseline and postintervention. After controlling for physical baseline value, age, sex, residential care facilities, and body mass index, the MCE-G showed positive effects both on mobility (p < .001) and balance (p = .001). The role of balance as mediator in the relationship between participation to the MCE program and mobility was demonstrated.
Mary K. Wolfe and Noreen C. McDonald
Independent travel among youth has diminished and rates of obesity have increased. It remains empirically unclear what factors influence the degree to which parents allow, or even enable, their children to be independently mobile. We analyze the association between parental perceptions of the social environment and the degree of independent mobility among children.
Surveys were conducted with 305 parents of 10- to 14-year-olds in the Bay Area during 2006 and 2007. The social environment was measured with scales assessing parental perceptions of child-centered social control, intergenerational closure, social cohesion, and safety from crime and traffic. Independent mobility was measured as a composite variable reflecting the degree to which a child is allowed to do the following without adult accompaniment: travel to neighborhood destinations, walk around the neighborhood, cross main roads, and ride transit.
We find modest evidence of an association between parental perceptions of social cohesion and safety from traffic and independent mobility outcomes among children. Age is positively associated with increased independent mobility and Hispanic children experience greater restrictions on independent mobility.
Interventions aimed at increasing physical activity among children through greater independent mobility should include neighborhood-level efforts to grow social cohesion and trust.