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.
Ching-Yi Wang, Ming-Hsia Hu, Hui-Ya Chen and Ren-Hau Li
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.
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.
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.
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.
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.
Daniel Leightley, Moi Hoon Yap, Jessica Coulson, Mathew Piasecki, James Cameron, Yoann Barnouin, Jon Tobias and Jamie S. McPhee
gait cycle and transitions from sit to stand, which increases the risk of falls ( Rubenstein, 2006 ). The reduced postural control and mobility may occur in part due to the increased tendency for older people to be sedentary ( McPhee et al., 2016 ). Relatively short-term exercise training lasting just
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.
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.