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.
William P. Berg and Brian A. Lapp
Sandra C. Webber and Michelle M. Porter
This exploratory study examined the feasibility of using Garmin global positioning system (GPS) watches and ActiGraph accelerometers to monitor walking and other aspects of community mobility in older adults. After accuracy at slow walking speeds was initially determined, 20 older adults (74.4 ± 4.2 yr) wore the devices for 1 day. Steps, distances, and speeds (on foot and in vehicle) were determined. GPS data acquisition varied from 43 min to over 12 hr, with 55% of participants having more than 8 hr between initial and final data-collection points. When GPS data were acquired without interruptions, detailed mobility information was obtained regarding the timing, distances covered, and speeds reached during trips away from home. Although GPS and accelerometry technology offer promise for monitoring community mobility patterns, new GPS solutions are required that allow for data collection over an extended period of time between indoor and outdoor environments.
Patricia E. Longmuir and Roy J. Shephard
The Arm CAFT is a simple submaximal arm ergometer test for subjects with mobility disabilities, designed to match the Canadian Aerobic Fitness Test (CAFT) in both administration and interpretation. It is here evaluated relative to direct arm ergometer measurements of peak oxygen intake in 41 men and women with mobility disabilities, aged 20-60, who were attending an “integrated” sports facility. Peak oxygen intake was predicted using the original CAFT equation, but the oxygen cost of arm ergometer test stages was substituted and predictions were scaled downward by 70/100 to allow for the lower peak aerobic power of the upper limbs. In 16 subjects who maintained cranking cadence, predictions were reliable over 1 week, with a small increase of score at the second test. Although the Arm CAFT protocol is reliable and free of bias, it has only a limited validity, and only a minority of the stronger individuals with mobility disabilities can sustain the required cranking rhythm.
Yen-Jong Chen, Rodney H. Matsuoka and Kun-Cheng Tsai
Mobility barriers can impede physical activity, increase the fear of falling, and pose a threat to the ability of older adults to live independently. This study investigated outdoor mobility barriers within a nonretirement public housing community located in Tainan, Taiwan. Site observations and interviews with older adult residents determined that parked motor scooters, potted plants, the rubber tiles of play areas, and a set of steps were the most important barriers. In addition, the space syntax parameters of control value and mean depth were effectively able to quantitatively measure improvements in walkability resulting from the hypothesized removal of these four barriers. These measures of improved walkability can be included in a cost-benefit analysis of spatial improvement factors to help policymakers address the mobility and accessibility needs of older adults.
Madeleine E. Hackney, Courtney D. Hall, Katharina V. Echt and Steven L. Wolf
Evidence-based recommendations for interventions to reduce fall risk in older adults with visual impairment are lacking. Adapted tango dance (Tango) and a balance and mobility program (FallProof) have improved mobility, balance, and quality of life (QOL) in individuals with movement impairment. This study compared the efficacy of Tango and FallProof for 32 individuals with visual impairment (age: M = 79.3, SD =11 [51–95 years]). Participants were assigned to Tango or FallProof to complete twenty, 90-min lessons within 12 weeks. Participants underwent assessment of balance, dual-tasking, endurance, gait, and vision-related QOL. The balance reactions of participants in both groups improved (p < .001). Endurance, cognitive dual-tasking, and vision-related QOL may have improved more for Tango than FallProof. Group differences and gains were maintained across time. Both programs could be effective options for motor rehabilitation for older adults with visual impairment because they may improve mobility and QOL while reducing fall risk.
L. Jerome Brandon, Lisa W. Boyette, Deborah A. Gaasch and Adrienne Lloyd
This study evaluated the effects of a 4-month lower extremity strength-training program on mobility in older adults. Eighty-five older adults (43 experimental, ES, and 42 comparison, CS) with a mean age of 72.3 years served as participants. The ES strength-trained plantar flexors (PF), knee flexors (KF), and knee extensors (KE) 1 hr/day, 3 days a week for 4 months. Both the ES and CS were evaluated for PF, KF, and KE strength (1 RM) and the time required to complete floor rise, chair rise, 50-ft walk, and walking up and down stairs before and after the training intervention. The ES increased (p < .05) both absolute (51.9%) and relative strength (1 RM/body weight, 52.4%) after training. Only chair-rise and floor-rise tasks improved significantly after training. Baseline and posttraining mobility tasks predicted from 1 RMs had low to moderate R values. These results suggest that strength is necessary for mobility, but increasing strength above baseline provides only marginal improvement in mobility for reasonably fit older adults.
Ching-Yi Wang, Sharon L. Olson and Elizabeth J. Protas
The purposes of this study were to evaluate community-dwelling elderly adults with different levels of perceived mobility with 5 physical-performance tests, determine the cutoff values of the 5 tests, and identify the best tests for classifying mobility status. The community-mobility statuses of 203 community-dwelling elders were classified as able, decreased, or disabled based on their self-reported ability to walk several blocks and climb stairs. They also performed the functional reach, timed 50-ft walk, timed 5-step, timed floor transfer, and 5-min-walk endurance tests. We found in all tests that the “able” outperformed the “decreased” and that the “decreased” outperformed the “disabled,” except on the floor-transfer task. The optimum cutoff values of the 5 performance tests were also reported. The 5-min walk and timed 5-step test could best separate the “able” from the “decreased,” whereas the 50-ft-walk-test could best differentiate the “decreased” from the “disabled.” The results suggest that community-mobility function of older adults can be captured by performance tests and that the cutoff values of the 5-min-walk, 5-step, and 50-ft-walk tests can be used in guiding intervention or prevention programs.
Lorraine Y. Morphy and Donna Goodwin
This exploratory study described the experiences of choice in physical activity contexts for adults with mobility impairments. The experiences of 3 female and 2 males with mobility impairments between 18 and 23 years of age were described using the interpretive phenomenological methods of individual interviews, written stories, and field notes. Thematic analysis revealed three themes: (a) interpreting the setting described participants’ interpretation of the environment, person, and task when making movement choices; (b) alternative selection described how participants actively engaged in analyzing alternatives and choosing among them; and (c) implications of choices made described participants’ evaluations of good and bad choices and what was learned. Evidence of effective choice making among adults with physical impairments suggests the potential efficacy of ecological task analysis as a pedagogical tool in physical activity contexts.
Kelly P. Arbour-Nicitopoulos and Kathleen A. Martin Ginis
This study descriptively measured the universal accessibility of “accessible” fitness and recreational facilities for Ontarians living with mobility disabilities. The physical and social environments of 44 fitness and recreational facilities that identified as “accessible” were assessed using a modified version of the AIMFREE. None of the 44 facilities were completely accessible. Mean accessibility ratings ranged between 31 and 63 out of a possible 100. Overall, recreational facilities had higher accessibility scores than fitness centers, with significant differences found on professional support and training, entrance areas, and parking lot. A modest correlation was found between the availability of fitness programming and the overall accessibility of fitness-center specific facility areas. Overall, the physical and social environments of the 44 fitness and recreational facilities assessed were limited in their accessibility for persons with mobility disabilities. Future efforts should be directed at establishing and meeting universal accessibility guidelines for Canadian physical activity facilities.
James D. Sessford, Mary Jung, Lawrence R. Brawley and Jennifer L. Forbes
Among older adults, preserving community mobility (CM) is important for maintaining independent living. We explored whether perceptions of the environment and self-efficacy for CM (SE-CM) would predict walking performance for tasks reflecting CM. We hypothesized that perceptions of the environment and SE-CM would be additive predictors of walking performance on tasks reflecting the complexity of CM. Independent living older adults (N = 60) aged 64-85 completed six complex walking tasks (CWTs), SE-CM, and the environmental analysis of mobility questionnaire (EAMQ). Multiple regression analyses indicated that for each CWT, the EAMQ scales predicted walking performance (range: model R2Adj. = .078 to .139, p < .04). However, when SE-CM was added to the models, it was the sole significant predictor (p < .05). Contrary to our hypotheses, SE-CM was the best predictor in the additive models. SE-CM may be more correspondent to walking tests and thus a more sensitive predictor of CM walking performance.