The purpose of this study was to pilot test a function-focused exercise intervention consisting of strength and gait-speed training in elders with reduced walking speed, decreased walking endurance, and functional impairment. Twelve participants, 77.2 years old (± 7.34), whose usual gait speed was <0.85 m/s, with walking endurance of <305 m in 5 min, and who were functionally impaired participated in a moderate-intensity exercise intervention. The training occurred 3 times per week, 75 min per session, for 3 months and combined 4 weeks of gait-speed training, walking exercise, and functional strengthening. The participants demonstrated mean usual gait speeds (≥1.0 m/s), endurance (≥350 m), and functional ability (≥10 score on performance battery) that were within normal limits after 12 weeks of training. Fastest gait speed (≥1.5 m/s) and muscle strength also improved significantly. Improvements were maintained during follow-up testing after 3–6 months. In summary, a 12-week intervention for frail, mobility-disabled participants led to improvements in walking, function, and strength.
Elizabeth J. Protas and Sandrine Tissier
Anthony P. Marsh, Elizabeth A. Chmelo, Jeffrey A. Katula, Shannon L. Mihalko and W. Jack Rejeski
The purpose of this study was to determine whether a walking program supplemented by tasks designed to challenge balance and mobility (WALK+) could improve physical function more than a traditional walking program (WALK) in older adults at risk for mobility disability. 31 community-dwelling older adults (M ± SD age = 76 ± 5 yr; Short Physical Performance Battery [SPPB] score = 8.4 ± 1.7) were randomized to treatment. Both interventions were 18 sessions (1 hr, 3×/wk) and progressive in intensity and duration. Physical function was assessed using the SPPB and the 400-m-walk time. A subset of participants in the WALK group who had relatively lower baseline function showed only small improvement in their SPPB scores after the intervention (0.3 ± 0.5), whereas a subset of participants in the WALK+ group with low baseline function showed substantial improvement in their SPPB scores (2.2 ± 0.7). These preliminary data underscore the potential importance of tailoring interventions for older adults based on baseline levels of physical function.
Minna Rasinaho, Mirja Hirvensalo, Raija Leinonen, Taru Lintunen and Taina Rantanen
The purpose of this study was to investigate what older adults with severe, moderate, or no mobility limitation consider motives for and barriers to engaging in physical exercise. Community-dwelling adults (N = 645) age 75–81 years completed a questionnaire about their motives for and barriers to physical exercise and answered interview questions on mobility limitation. Those with severely limited mobility more often reported poor health, fear and negative experiences, lack of company, and an unsuitable environment as barriers to exercise than did those with no mobility limitation. They also accentuated disease management as a motive for exercise, whereas those with no or moderate mobility limitation emphasized health promotion and positive experiences related to exercise. Information about differences in motives for and barriers to exercise among people with and without mobility limitation helps tailor support systems that support engagement in physical activity among older adults.
Deborah Laliberte Rudman and Michelle Durdle
This secondary analysis of data drawn from a descriptive phenomenological study explored how older adults with low vision experience and manage community mobility. Participants included 34 urban and rural older adults, age 70 years and older, who were not using low-vision-rehabilitation services. The findings convey a core element of the experience of community mobility for participants: living with a pervasive sense of fear regarding one’s body and way of being. Participants continually gauged risks associated with mobility and engaged in risk avoidance and management strategies. Community mobility was often restricted by participants because of perceived risks, leading to reduced participation in a range of physical, social, and other types of activities. Further research on environmental factors mediating community mobility and on strategies effective in maintaining mobility among seniors with low vision is essential to optimize participation, health, and service delivery.
Francisco Alvarez-Barbosa, Jesús del Pozo-Cruz, Borja del Pozo-Cruz, Antonio García-Hermoso and Rosa María Alfonso-Rosa
The aging process is characterized by reductions in dynamic and postural balance, muscle mass, and mobility ( Janssen, Heymsfield, & Ross, 2002 ). The histological features of aging muscle suggest that denervation contributes to muscle atrophy ( Mosole et al., 2014 ) and muscle weakness ( Joyner
Hayley E. Christian, Charlotte D. Klinker, Karen Villanueva, Matthew W. Knuiman, Sarah A. Foster, Stephan R. Zubrick, Mark Divitini, Lisa Wood and Billie Giles-Corti
Relationships between context-specific measures of the physical and social environment and children’s independent mobility to neighborhood destination types were examined.
Parents in RESIDE’s fourth survey reported whether their child (8–15 years; n = 181) was allowed to travel without an adult to school, friend’s house, park and local shop. Objective physical environment measures were matched to each of these destinations. Social environment measures included neighborhood perceptions and items specific to local independent mobility.
Independent mobility to local destinations ranged from 30% to 48%. Independent mobility to a local park was less likely as the distance to the closest park (small and large size) increased and less likely with additional school grounds (P < .05). Independent mobility to school was less likely as the distance to the closest large park increased and if the neighborhood was perceived as unsafe (P < .05). Independent mobility to a park or shops decreased if parenting social norms were unsupportive of children’s local independent movement (P < .05).
Independent mobility appears dependent upon the specific destination being visited and the impact of neighborhood features varies according to the destination examined. Findings highlight the importance of access to different types and sizes of urban green space for children’s independent mobility to parks.
Anni Rava, Anu Pihlak, Jaan Ereline, Helena Gapeyeva, Tatjana Kums, Priit Purge, Jaak Jürimäe and Mati Pääsuke
The purpose of this study was to evaluate the differences in body composition, neuromuscular performance, and mobility in healthy, regularly exercising and inactive older women, and examine the relationship between skeletal muscle indices and mobility. Overall, 32 healthy older women participated. They were divided into groups according to their physical activity history as regularly exercising (n = 22) and inactive (n = 10) women. Body composition, hand grip strength, leg extensor muscle strength, rapid force development, power output, and mobility indices were assessed. Regularly exercising women had lower fat mass and higher values for leg extensor muscle strength and muscle quality, and also for mobility. Leg extensor muscle strength and power output during vertical jumping and appendicular lean mass per unit of body mass were associated with mobility in healthy older women. It was concluded that long-term regular exercising may have beneficial effects on body composition and physical function in older women.
Chantale Ferland, Hélène Moffet and Désirée B. Maltais
Ambulatory children and youth with cerebral palsy have limitations in locomotor capacities and in community mobility. The ability of three locomotor tests to predict community mobility in this population (N = 49, 27 boys, 6–16 years old) was examined. The tests were a level ground walking test, the 6-min-Walk-Test (6MWT), and two tests of advanced locomotor capacities, the 10-meter-Shuttle-Run-Test (10mSRT) and the Timed-Up-and-Down-Stairs-Test (TUDS). Community mobility was measured with the Assessment of Life Habits mobility category. After age and height were controlled, regression analysis identified 10mSRT and TUDS values as significant predictors of community mobility. They explained about 40% of the variance in the Life Habits mobility category scores. The 10mSRT was the strongest predictor (standardized Beta coefficient = 0.48, p = 0.002). The 6MWT was not a significant predictor. Thus, advanced locomotor capacity tests may be better predictors of community mobility in this population than level ground walking tests.
Ching-Yi Wang, Ming-Hsia Hu, Hui-Ya Chen and Ren-Hau Li
To determine the test–retest reliability and criterion validity of self-reported function in mobility and instrumental activities of daily living (IADL) in older adults, a convenience sample of 70 subjects (72.9 ± 6.6 yr, 34 male) was split into able and disabled groups based on baseline assessment and into consistently able, consistently disabled, and inconsistent based on repeat assessments over 2 weeks. The criterion validities of the self-reported measures of mobility domain and IADL-physical subdomain were assessed with concurrent baseline measures of 4 mobility performances, and that of the self-reported measure of IADL-cognitive subdomain, with the Mini-Mental State Examination. Test–retest reliability was moderate for the mobility, IADL-physical, and IADL-cognitive subdomains (κ = .51–.66). Those who reported being able at baseline also performed better on physical- and cognitive-performance tests. Those with variable performance between test occasions tended to report inconsistently on repeat measures in mobility and IADL-cognitive, suggesting fluctuations in physical and cognitive performance.
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.