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William P. Berg and Brian A. Lapp

The purpose of this study was to examine the effect of a practical resistance training program for the lower extremities on mobility in independent, community-dwelling older adults. Twenty-two volunteers with a mean age of 72.9 years underwent two identical pretests 1 month apart. Lower extremity strength, locomotor stability, preferred gait velocity, and step lime in obstacle clearance were assessed. Participants then engaged in an 8-week resistance training program for the lower extremities using adjustable ankle weights. Following a posttest, a repeated-measures ANOVA was used to determine whether changes in strength and mobility when the treatment was interjected differed from when it was not. Results indicated that the training had a limited effect on strength and no effect on mobility. The feasibility of practical resistance training interventions to counteract muscle weakness and associated immobility in independent older adults is discussed.

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Ann-Charlotte Grahn Kronhed, Claes Möller, Boel Olsson and Margareta Möller

This study evaluated a balance-training program’s influence in healthy older adults. Fifteen community-dwelling participants aged 70–75 years were randomized to an exercise group, and 15 gender- and age-matched participants, to a control group. The 9-week training program comprised ordinary-life balance, vestibular-habituation, and ball exercises and station training. Clinical balance tests were conducted before and after training. Tests that showed significant improvement in the exercise group after the intervention included standing on the right leg with eyes closed, standing on the right leg and the left leg while turning the head and walking 30 m. Significant between-group differences were found at posttest. A significant decrease was seen in the control group in the walking-forward test, and this change was significantly different between groups. The study indicates that balance performance in healthy older adults might be improved by balance training including exercises that stimulate multiple sensory systems and their central integration.

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Jiska Cohen-Mansfield, Marcia S. Marx and Jack M. Guralnik

This study aimed to ascertain perceived barriers and motivators to exercise in people age 74–85 and to clarify the meaning of these barriers and motivators by examining participant characteristics that relate to them. 324 community-dwelling participants age 74–85 completed a health questionnaire that included items on barriers and motivators to exercise, as well as questions on demographic variables, health, and exercise. Selected participants then completed a physical-performance battery to measure functional performance. Barriers and motivators were related internally, as well as to many other factors including pain and depressed affect on the Geriatric Depression Scale. The findings suggest a need for individualized and comprehensive approaches to the presentation of exercise programs. Health interventions are needed that will address both physical pain and depressed affect and explain the importance of exercise even in the presence of health problems. An understanding of the context of reported barriers and motivators is necessary for correct interpretation and program development.

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Ro DiBrezzo, Barbara B. Shadden, Blake H. Raybon and Melissa Powers

Loss of balance and falling are critical concerns for older adults. Physical activity can improve balance and decrease the risk of falling. The purpose of this study was to evaluate a simple, low-cost exercise program for community-dwelling older adults. Sixteen senior adults were evaluated using the Senior Fitness Test for measures of functional strength, aerobic endurance, dynamic balance and agility, and flexibility. In addition, measures of height, weight, resting blood pressure, blood lipids, and cognitive function were obtained. Participants then attended a 10-week exercise class including stretching, strengthening, and balance-training exercises. At the completion of the program, significant improvements were observed in tests measuring dynamic balance and agility, lower and upper extremity strength, and upper extremity flexibility. The results indicate that exercise programs such as this are an effective, low-cost solution to improving health and factors that affect falling risk among older adults.

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Nicole Kahle and Michael A. Tevald

To determine the effect of core muscle strengthening on balance in community-dwelling older adults, 24 healthy men and women between 65 and 85 years old were randomized to either exercise (EX; n = 12) or control (CON; n = 12) groups. The exercise group performed a core strengthening home exercise program thrice weekly for 6 wk. Core muscle (curl-up test), functional reach (FR) and Star Excursion Balance Test (SEBT) were assessed at baseline and follow-up. There were no group differences at baseline. At follow-up, EX exhibited significantly greater improvements in curl-up (Cohen’s d = 4.4), FR (1.3), and SEBT (>1.9 for all directions) than CON. The change in curl-up was significantly correlated with the change in FR (r = .44, p = .03) and SEBT (r > .61, p ≤ .002). These results suggest that core strengthening should be part of a comprehensive balance-training program for older adults.

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Mark W. Swanson, Eric Bodner, Patricia Sawyer and Richard M. Allman

Little is known about the effect of reduced vision on physical activity in older adults. This study evaluates the association of visual acuity level, self-reported vision, and ocular disease conditions with leisure-time physical activity and calculated caloric expenditure. A cross-sectional study of 911 subjects 65 yr and older from the University of Alabama at Birmingham Study of Aging (SOA) cohort was conducted evaluating the association of vision-related variables to weekly kilocalorie expenditure calculated from the 17-item Leisure Time Physical Activity Questionnaire. Ordinal logistic regression was used to evaluate possible associations while controlling for potential confounders. In multivariate analyses, each lower step in visual acuity below 20/50 was significantly associated with reduced odds of having a higher level of physical activity, OR 0.81, 95% CI 0.67, 0.97. Reduced visual acuity appears to be independently associated with lower levels of physical activity among community-dwelling adults.

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Rebecca L. Vivrette, Laurence Z. Rubenstein, Jennifer L. Martin, Karen R. Josephson and B. Josea Kramer

Objective:

To determine seniors’ beliefs about falls and design a fall-risk self-assessment and educational materials to promote early identification of evidence-based fall risks and encourage prevention behaviors.

Methods:

Focus groups with community-dwelling seniors, conducted in two phases to identify perceptions about fall risks and risk reduction and to assess face validity of the fall-risk self-assessment and acceptability of educational materials.

Results:

Lay perception of fall risks was in general concordance with evidence-based research. Maintaining independence and positive tone were perceived as key motivators for fall prevention. Seniors intended to use information in the educational tool to stimulate discussions about falls with health care providers.

Implications:

An evidence-based, educational fall-risk self-assessment acceptable to older adults can build on existing lay knowledge about fall risks and perception that falls are a relevant problem and can educate seniors about their specific risks and how to minimize them.

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Katherine B. Gunter, Jennifer De Costa, Karen N. White, Karen Hooker, Wilson C. Hayes and Christine M. Snow

This study assessed changes in balance self-efficacy (BSE) over 1 year in community-dwelling elderly, compared changes in BSE between fallers and nonfallers, and assessed the relationship between specific balance and mobility risk factors for side falls and BSE scores. Elderly fallers (n = 67; 80.2 ± 5.9 years) and nonfallers (n = 75; 79.4 ± 4.9), categorized based on self-reported falls over 1 year, were tested at baseline on postural sway, hip-abduction strength, lateral-stepping velocity, tandem walk, and get-up-and-go and given a BSE questionnaire. Fallers had lower BSE scores than nonfallers did (141.6 ± 33.5 and 154.9 ± 25.4; p = .008). BSE did not change over 1 year. In stepwise regression, BSE scores were predictive of time on the get-up-and-go, mediolateral sway, and tandem walk independent of age, height, and strength (p < .001). The BSE scale might be useful for screening individuals at risk for injurious falls because it is inexpensive and noninvasive.

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Martin G. Jorgensen, Uffe Laessoe, Carsten Hendriksen, Ole B.F. Nielsen and Per Aagaard

The aims of the current study were to examine the intrarater intersession reproducibility of the Nintendo Wii agility and stillness tests and explore the concurrent validity in relation to gold-standard force-plate analysis. Within-day intersession reproducibility was examined in 30 older adults (age 71.8 ± 5.1 yr). No systematic test–retest differences were found for the Wii stillness test; however, the Wii agility test scores differed systematically between test sessions (p < .05). The Wii stillness test yielded a test–retest ICC of .86 (95% CI 0.74–0.93), CV of 6.4%, LOA of 11.0, and LOA% of 17.9%. Likewise for the Wii agility test ICC was .73 (95% CI 0.50-0.86), CV 5.3%, LOA 1.8, and LOA% of 14.6%. Wii stillness scores correlated to force plate measures (r = .65–.82, p < .01), reflecting moderate to excellent validity. In conclusion, it appears that the Wii stillness test represents a low-cost, objective, reproducible, and valid test of undisturbed postural balance in community-dwelling older adults.

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Jeanne F. Nichols, Lori M. Hitzelberger, Jennifer G. Sherman and Patricia Patterson

This study examined the efficacy of a progressive resistance exercise program, using equal concentric/eccentric (CE) or greater eccentric/concentric (GE) workloads, for increasing strength and improving functional abilities of community-dwelling older adults. Sixty men and women were randomly assigned to one of three groups: CE, GE, or control. All strength testing and training took place on six Lifecircuit machines. Functional tests included a bas carry, weighted stair climb, shelf task 1-RM, and static balance. Significant interactions in strength tests were noted for the chest, back, and shoulder exercises. GE improved in shoulder strength more than CE and control For functional measures, all weight trainers were grouped and compared to controls. A significant interaction occurred for the stair climb and balance with the exercise groups decreasing stair climb time by 11% and increasing balance time by 26%. Relative improvements by weight trainers of 12% for the shelf task and 7% for the bag carry were not significant. These data indicate that a moderate intensity resistance program can have positive effects on tasks required for everyday function.