The impact of proprioceptive neuromuscular facilitation (PNF) on physical function in assisted-living older adults (73-94 years old) was studied. A 5-week pretraining period consisting of weekly visits by trainers to participants preceded a 10-week training period of warm-up, PNF exercises, and cool-down. Training progressed from 1 set of 3 repetitions to 3 sets of 3 repetitions. Assessments were conducted at baseline (T1), postpretraining (T2), and posttraining (T3). Eleven of 14 volunteer participants completed the study. Physical function was assessed by range of motion (ROM), isometric strength, and balance and mobility measures. Repeated-measures ANOVA identified 6 measures (sit-to-stand, shoulder- and ankle-flexion ROM, and hip-extension, ankle-flexion, and ankle-extension strength) with statistically significant differences. With the exception of hip-extension strength, these measures were statistically significant from T2 to T3 in post hoc univariate tests. Results indicate that PNF flexibility training can improve ROM, isometric strength, and selected physical-function tasks in assisted-living older adults.
Diane Austrin Klein, William J. Stone, Wayne T. Phillips, Jaime Gangi and Sarah Hartman
Andrew A. Pellett, Leann Myers, Michael Welsch, S. Michal Jazwinski and David A. Welsh
Diastolic dysfunction, often seen with increasing age, is associated with reduced exercise capacity and increased mortality. Mortality rates in older individuals are linked to the development of disability, which may be preceded by functional limitations. The goal of this study was to identify which echocardiographic measures of diastolic function correlate with physical function in older subjects. A total of 36 men and women from the Louisiana Healthy Aging Study, age 62–101 yr, received a complete echocardiographic exam and performed the 10-item continuous-scale physical-functional performance test (CS-PFP-10). After adjustment for age and gender, left atrial volume index (ρ = –0.59; p = .0005) correlated with the total CS-PFP-10 score. Increased left atrial volume index may be a marker of impaired performance of activities of daily living in older individuals.
Claire Peel, Carolyn Utsey and Jan MacGregor
This study aimed to evaluate the effects of an 8-week supervised exercise program on physiological measurements during treadmill walking, muscle strength, functional performance, and health status in older adults limited in physical function. Twenty-four participants were randomly assigned to an exercise group (EG, N = 13) or a control group (CG, N = 11), and were evaluated before and after the exercise program (EG) or 8-week period (CG). Evaluations included a progressive treadmill lest, strength testing, the Physical Performance Test (PPT), and the SF-36 Health Survey. The exercise program consisted of 3 sessions per week of brisk walking and strengthening exercises. The EG demonstrated increases in cardiorespiratory fitness and increases in treadmill walking time. The EG also demonstrated increases in force production in 3 of the 6 muscle groups that were tested. Both the EG and CG demonstrated improvements in PPT scores and in 2 health concepts on the SF-36 Health Survey.
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.
Marcia G. Ory, Matthew Lee Smith, Luohua Jiang, Doris Howell, Shuai Chen, Jairus C. Pulczinski and Alan B. Stevens
This study examines the effectiveness of Texercise Select, a 12-week lifestyle program to improve physical functioning (as measured by gait speed) and quality of life. Baseline and 12-week follow-up assessments were collected from 220 enrollees who were older (mean = 75 years), predominantly female (85%), White (82%), and experiencing multiple comorbidities (mean = 2.4). Linear mixed-models were fitted for continuous outcome variables and GEE models with logit link function for binary outcome variables. At baseline, over 52% of participants had Timed Up-and-Go (TUG) test times of 12 s or more, which indicates below-normal performance. On average, participants showed significant reductions in TUG test scores at the postintervention (11% reduction, p < .001). Participants also showed significant improvements in general health status (p = .002), unhealthy physical days (p = .032), combined unhealthy physical and mental days (p = .006), and days limited from usual activity (p = .045). Findings suggest that performance indicators can be objectively collected and integrated into evaluation designs of community-based, activity-rich lifestyle programs.
Christopher J. Dondzila, Keith P. Gennuso, Ann M. Swartz, Sergey Tarima, Elizabeth K. Lenz, Stephanie S. Stein, Randal J. Kohl and Scott J. Strath
The aim of this study was to examine the dose-response relationship between walking activity and physical function (PF) in community-dwelling older adults. Physical activity (PA, pedometry) and PF (self-report [SF-36] and 6-minute walk test [6MWT]) were assessed in 836 individuals. Accumulated PA was categorized into four groups (1 = ≤ 2,500; 2 = 2,501–5,000; 3 = 5,001–7,500; and 4 = ≥ 7,501 steps/day). Across individual groups 1–4, SF-36 scores increased from 66.9 ± 25.0% to 73.5 ± 23.2% to 78.8 ± 19.7% to 81.3 ± 20.6%, and 6MWT increased from 941.7 ± 265.4 ft to 1,154.1 ± 248.2 ft to 1,260.1 ± 226.3 ft to 1,294.0 ± 257.9 ft. Both SF-36 and 6MWT scores were statistically different across all groups, apart from groups 3 and 4. PA and ranks of groups were highly significant predictors (p < .0001) for both SF-36 and 6MWT. There was a positive dose-response relationship evident for both SF-36 and 6MWT with increasing levels of PA. Low levels of PA appear to be an important indicator of poor functionality in older adults.
Michael P. Corcoran, Miriam E. Nelson, Jennifer M. Sacheck, Kieran F. Reid, Dylan Kirn, Roger A. Fielding, Kenneth K.H. Chui and Sara C. Folta
For adults aged 65 years and older, physical function is a strong predictor of subsequent disability and loss of independence ( Hirvensalo, Rantanen, & Heikkinen, 2000 ; Newman et al., 2006 ). Older adults with mobility disability have higher rates of hospitalization, depression, morbidity, and
Cheryl Der Ananian, Renae Smith-Ray, Brad Meacham, Amy Shah and Susan Hughes
, & Castro, 2017 ; Resnicow, Baranowski, Ahluwalia, & Braithwaite, 1999 ). Exercise is considered a cornerstone in the management of arthritis ( Bennell, Dobson, & Hinman, 2014 ; Brosseau et al., 2015 ; Hochberg et al., 2012 ). Regular exercise is known to decrease pain, improve physical function, and may
Zakkoyya H. Lewis, Kyriakos S. Markides, Kenneth J. Ottenbacher and Soham Al Snih
We investigated the relationship between physical activity and physical function on the risk of falls over time in a cohort of Mexican-American adults aged 75 and older from the Hispanic Established Population for the Epidemiologic Study of the Elderly (H-EPESE). Participants were divided into four groups according to their level of physical activity and physical function: low physical activity and low physical function (n = 453); low physical activity and high physical function (n = 54); high physical activity and low physical function (n = 307); and high physical activity and high physical function (n = 197). Using generalized linear equation estimation, we showed that participants with high physical activity and low physical function had a greater fall risk over time, followed by the high physical activity and high physical function group. Participants seldom took part in activities that improve physical function. To prevent falls, modifications to physical activity should be made for older Mexican Americans.
Sarah Roberts, Elizabeth Awick, Jason T. Fanning, Diane Ehlers, Robert W. Motl and Edward McAuley
Previous evidence suggests physical activity interventions effectively produce short-term improvements in physical function for older adults. The present study examined whether improvements in physical function after a DVD-delivered exercise intervention were maintained 18 months postintervention. Older adults (n = 153) randomized to a 6-month DVD-delivered exercise intervention or an attentional control condition were contacted 18 months postintervention. Participants completed the Short Physical Performance Battery (SPPB) and measures of flexibility, strength, and functional limitations were taken. Analyses of variance were conducted to determine if improvements in physical function as a result of the intervention were maintained at follow-up. Improvements in the SPPB, F (1,125) = 3.70, p = .06, η2 = .03, and upper body strength, F (1,121) = 3.04, p = .08, η2 = .03 were maintained for the intervention condition. Home-based DVD exercise training interventions may hold promise for long-term maintenance of physical function in older adults.