This study examined participant demographic and physical function characteristics from EnhanceFitness, an evidence-based physical activity program for older adults. The sample consisted of 19,964 older adults. Participant data included self-reported health and demographic variables, and results for three physical function tests: chair stand, arm curls, and timed up-and-go. Linear regression models compared physical function test results among eight program site types. Participants were, on average, 72 years old, predominantly female, and reported having one chronic condition. Residential site participants’ physical function test results were significantly poorer on chair stand and timed up-and-go measures at baseline, and timed up-and-go at a four-month follow-up compared with the reference group (senior centers) after controlling for demographic variables and site clustering. Evidence-based health-promotion programs offered in community settings should assess demographic, health, and physical function characteristics to best serve participants’ specific needs, and offer classes tailored to participant function and ability while maintaining program fidelity.
Marlana J. Kohn, Basia Belza, Miruna Petrescu-Prahova, Christina E. Miyawaki and Katherine H. Hohman
Cadeyrn J. Gaskin and Tony Morris
The purpose of this research was to investigate the relationships between physical activity, health-related quality of life (HRQL), and psychosocial functioning (mood states, physical self-efficacy, social support) in adults with cerebral palsy (N = 51). The data was heavily skewed, with many participants reporting that they performed minimal physical activity and experienced low levels of physical function, minimal role limitations, high social functioning, low levels of negative mood states, and high social support. With the exception of the correlations between physical activity and physical functioning (ρ = .45), role limitations—physical (ρ = .32), vigor–activity mood state (ρ = .36), and social support from friends (ρ = –.43), there were typically weak associations between physical activity and the subscales of the HRQL and psychosocial functioning measures. These low associations might be the result of the participants’ psychological adaptations to cerebral palsy during their lives.
Lucelia Luna de Melo, Verena Menec, Michelle M. Porter and A. Elizabeth Ready
This study examined the associations between walking behavior and the perceived environment and personal factors among older adults. Sixty participants age 65 yr or older (mean 77 ± 7.27, range 65–92) wore pedometers for 3 consecutive days. Perceived environment was assessed using the Neighborhood Environment Walk-ability Scale (abbreviated version). Physical function was measured using the timed chair-stands test. The mean number of steps per day was 5,289 steps (SD = 4,029). Regression analyses showed a significant association between personal factors, including physical function (relative rate = 1.05, p < .01) and income (RR = 1.43, p < .05) and the average daily number of steps taken. In terms of perceived environment, only access to services was significantly related to walking at the univariate level, an association that remained marginally significant when controlling for personal characteristics. These results suggest that among this sample of older adults, walking behavior was more related to personal and intrinsic physical capabilities than to the perceived environment.
Stephen M. Haley, Larry H. Ludlow and Jill T. Kooyoomjian
As a preliminary step in developing the physical-functioning measure of the Late-Life Function and Disability Instrument (LLFDI), the authors compared its items with the physical-functioning items (PF-10) on the SF-36 Health Survey. They compared the item coverage, hierarchy, and scale-separation properties of the PF-10 items with those of the physical-functioning items of the LLFDI. Both questionnaires were administered to 50 community-dwelling older adults. A partial-credit, 1-parameter, item-response-theory model was used to scale the items. The LLFDI improved the range of ability of daily activities that was encompassed by the PF-10 items by 46%. By sequentially deleting new items with poor fit to the overall scale and items with redundant content, the authors developed a scale more capable of accurately assessing low-functioning activities. The LLFDI function component incorporates a broader content range and better person and item separation than the PF-10 items. It appears to have potential as a comprehensive functional-activity assessment for community-dwelling older adults.
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.
Javier T. Gonzalez, Martin J. Barwood, Stuart Goodall, Kevin Thomas and Glyn Howatson
Unaccustomed eccentric exercise using large muscle groups elicits soreness, decrements in physical function and impairs markers of whole-body insulin sensitivity; although these effects are attenuated with a repeated exposure. Eccentric exercise of a small muscle group (elbow flexors) displays similar soreness and damage profiles in response to repeated exposure. However, it is unknown whether damage to small muscle groups impacts upon whole-body insulin sensitivity. This pilot investigation aimed to characterize whole-body insulin sensitivity in response to repeated bouts of eccentric exercise of the elbow flexors. Nine healthy males completed two bouts of eccentric exercise separated by 2 weeks. Insulin resistance (updated homeostasis model of insulin resistance, HOMA2-IR) and muscle damage profiles (soreness and physical function) were assessed before, and 48 h after exercise. Matsuda insulin sensitivity indices (ISIMatsuda) were also determined in 6 participants at the same time points as HOMA2-IR. Soreness was elevated, and physical function impaired, by both bouts of exercise (both p < .05) but to a lesser extent following bout 2 (time x bout interaction, p < .05). Eccentric exercise decreased ISIMatsuda after the first but not the second bout of eccentric exercise (time x bout interaction p < .05). Eccentric exercise performed with an isolated upper limb impairs whole-body insulin sensitivity after the first, but not the second, bout.
David E. Vance, Karlene K. Ball, Daniel L. Roenker, Virginia G. Wadley, Jerri D. Edwards and Gayla M. Cissell
Falls can impair health and reduce quality of life among older adults. Although many factors are related to falling, few analyses examine causal models of this behavior. In this study, factors associated with falling were explored simultaneously using structural-equation modeling. A variety of cognitive, physical-performance, and health measures were administered to 694 older adult drivers from the state of Maryland. The observed and latent variables of age, cognitive ability, physical functioning, health, and falling behavior were used to create a causal model. The model revealed that being older was associated with declines in cognition, and such cognitive declines predicted increased falling. Similarly, poorer health was related to poorer physical functioning, which, in turn, also predicted increased falling. This model indicates that in addition to existing fall-prevention interventions aimed at improving physical functioning, interventions to improve cognition and health might also be effective. It is speculated that fear of falling, which often results in reduced mobility among older adults, might account for the lack of a direct relationship between age and falling. This hypothesis should be examined in further research.
Keith P. Gennuso, Kathryn Zalewski, Susan E. Cashin and Scott J. Strath
To examine the effectiveness of the American College of Sports Medicine (ACSM) and the American Heart Association (AHA) resistance training (RT) guidelines to improve physical function and functional classification in older adults with reduced physical abilities.
Twenty-five at-risk older adults were randomized to a control (CON = 13) or 8-week resistance training intervention arm (RT = 12). Progressive RT included 8 exercises for 1 set of 10 repetitions at a perceived exertion of 5–6 performed twice a week. Individuals were assessed for physical function and functional classification change (low, moderate or high) by the short physical performance battery (SPPB) and muscle strength measures.
Postintervention, significant differences were found between groups for SPPB—Chair Stand [F(1,22) = 9.14, P < .01, η = .29] and SPPB—Total Score [F(1,22) = 7.40, P < .05, η = .25]. Functional classification was improved as a result of the intervention with 83% of participants in the RT group improving from low to moderate functioning or moderate to high functioning. Strength significantly improved on all exercises in the RT compared with the CON group.
A RT program congruent with the current ASCM and AHA guidelines is effective to improve overall physical function, functional classification, and muscle strength for older adults with reduced physical abilities.
Linda C. Campanelli
Functional mobility is generally considered a major contributor to maintaining quality of life at any age. There are several overviews of physiological aging relative to physical functioning and/or mobility in the recent literature. This paper reiterates the need for continued exercise (at all levels) throughout one’s lifetime, specifically to enhance quality of life and functional independence. Implications for professionals and program development are included. Tailored exercises for both ambulatory and nonambulatory older adults to maintain flexibility, gait, and bed mobility are described.
Danielle M. Thiel, Fatima Al Sayah, Jeff Vallance, Steven T. Johnson and Jeffrey A. Johnson
The objective was to investigate the longitudinal relationship between physical activity and health-related quality of life (HRQL) in adults with type 2 diabetes.
Data were from a prospective cohort of adults with type 2 diabetes. Weekly moderate-to-vigorous physical activity (MVPA) was reported using the Godin Leisure-Time Physical Activity Questionnaire, and HRQL was reported using the SF-12 and 5-level EQ-5D. Participants were categorized based on current weekly MVPA recommendations. Multivariable linear regression was used to explore associations between MVPA and HRQL, and multinomial logistic regression was used to assess the direction of change in HRQL after 1 year.
Mean age of participants (N = 1948) was 64.5 ± 10.8 years and 45% were female. Participants reported a mean of 84.1 ± 172.4 min of MVPA/week, and 21% (n = 416) met weekly MVPA recommendations. MVPA was associated with differences in the physical functioning (b = 5.42; P < .001), general health (b = 2.45; P = .037), and vitality (b = 2.83; P = .016) SF-12 dimensions. Participants who met recommendations were less likely to report a decline (vs. no change) in EQ-5D index score (OR = 0.75; 95% CI [0.57, 0.99]), and SF-12 physical component summary (OR = 0.67; 95% CI [0.50, 0.90]), compared with participants not meeting recommendations.
Participants who met weekly MVPA recommendations reported better physical functioning and were more likely to maintain their physical and overall HRQL over time.