For adults aged 65 years and older, physical function is a strong predictor of subsequent disability and loss of independence ( Hirvensalo, Rantanen, & Heikkinen, 2000 ; Newman et al., 2006 ). Older adults with mobility disability have higher rates of hospitalization, depression, morbidity, and
Michael P. Corcoran, Miriam E. Nelson, Jennifer M. Sacheck, Kieran F. Reid, Dylan Kirn, Roger A. Fielding, Kenneth K.H. Chui and Sara C. Folta
Lee Burton, Kyle Kiesel and Gray Cook
Column-editor : Carl G. Mattacola
Simon C. Darnell
Roberta E. Rikli and C. Jessie Jones
With the projected growth in the older adult population, preventing or delaying physical disability in later years has become a national goal. Evidence suggests that physiological decline, especially that associated with physical inactivity, is modifiable through proper assessment and activity intervention. However, a major limitation in reducing loss of function in later years is the lack of suitable assessment tools. Especially lacking are tests that can measure physical performance on a continuum across the wide range of functioning in the independent, community-residing older adult population. Of special concern is the ability to assess underlying physical parameters associated with common activities of daily living. Additional tools are needed for measuring physical performance in older adults, especially tools that meet established guidelines in terms of reliability, validity, discrimination power, and performance evaluation standards.
Claire Peel and Diane Ballard
The primary purpose of this study was to determine the reproducibility of the 6-min-walk test (6MWT) in older women. A secondary purpose was to document heart rate (HR), blood pressure (BP), and ratings of perceived exertion (RPE) in response to the 6MWT. Twenty-eight women with an average age of 80.0 years (±5.2) participated. They performed 2 trials of the 6MWT on 3 separate days, for a total of 6 trials. Heart rate, BP, RPE, and the total distance walked were recorded for each trial. The results indicated a significant increase from Trial 1 to Trial 2, with no differences between Trials 2–6, F(5, 131) = 7.02, p = .000. HR and BP were consistent across the 6 trials, and RPE was higher for the second trial on the second day of testing, F(5, 131) = 2.72, p = .023. The intraclass correlation coefficient for distance walked was .94. After the initial trial, performance on the 6MWT appears to be stable in older women.
Christie L. Ward, Rudy J. Valentine and Ellen M. Evans
Adiposity, lean mass, and physical activity (PA) are known to influence physical function in older adults, although the independent influences are not completely characterized. Older adults (N = 156, M age = 68.9 ± 6.7 yr, 85 men) were assessed for body composition via dual-energy X-ray absorptiometry, PA by accelerometer, and physical function via timed up-and-go (UP&GO), 30-s chair stand, 6-min walk (6-min WALK), and Star-Excursion Balance Test. In the absence of percentage-body-fat by PA interactions (p > .05), main effects existed such that a higher percentage body fat was associated with poorer performance in UP&GO, 30-s chair stand, and 6-min WALK (p < .05). No significant main effects were found for PA and functional performance. Adiposity explains 4.6–11.4% in physical functional variance (p < .05). Preventing increases in adiposity with age may help older adults maintain functional independence.
Priscilla G. MacRae, John F. Schnelle, Sandra F. Simmons and Joseph G. Ouslander
The purpose of this study was to describe the physical activity levels of ambulatory nursing home residents (N = 95) and identify factors that predicted these activity levels. The residents’ physical activity levels (standing, walking, and wheelchair propulsion), as measured by time-sampled observations and Caltrac motion sensors, indicated that restraint use was the major predictor of low physical activity. Both the physically restrained and the physically unrestrained groups, however, were inactive, with 93.8% and 83.5% of the observations, respectively, representing either lying or sitting. In the unrestrained group, scores measuring the resident’s fall risk, self-selected walking speed, upper and lower body strength, and body mass index were significant predictors of physical activity level. In the restrained group, scores measuring the resident’s fall risk and upper body strength were significant predictors of activity level.
Alison C. Novak and Brenda Brouwer
This study describes and contrasts the kinematics and kinetics of stair ambulation in people with chronic stroke and healthy control subjects. Three-dimensional motion data were collected from 10 persons with stroke (7 males) and 10 sex and age-matched older adults as they ascended and descended an instrumented staircase at self-selected speed with and without a handrail. Ankle, knee and hip joint angle and moment profiles were generated during stance and range of motion and peak moments were contrasted between groups, sides (stroke only) and condition. Cadence was lower in stroke than controls, although the kinematic profiles appeared similar during ascent and decent. Notable differences in joint kinetics were evident as the peak extensor moments were typically lower on the affected side in stroke compared with controls and the less affected side. These differences accounted for the lower magnitude net extensor support moment. The lower affected side hip abductor moments likely limited lateral stability. Handrail use tended to reduce the peak moments on the affected side only leading to more side-to-side differences than occurred without the handrail. The findings reveal differences in task performance between stroke and healthy groups that help inform rehabilitation practice.
Marie-Louise Bird, Keith Hill, Madeleine Ball and Andrew D. Williams
This research explored the balance benefits to untrained older adults of participating in community-based resistance and flexibility programs. In a blinded randomized crossover trial, 32 older adults (M = 66.9 yr) participated in a resistance-exercise program and a flexibility-exercise program for 16 weeks each. Sway velocity and mediolateral sway range were recorded. Timed up-and-go, 10 times sit-to-stand, and step test were also assessed, and lower limb strength was measured. Significant improvements in sway velocity, as well as timed up-and-go, 10 times sit-to-stand, and step test, were seen with both interventions, with no significant differences between the 2 groups. Resistance training resulted in significant increases in strength that were not evident in the flexibility intervention. Balance performance was significantly improved after both resistance training and standing flexibility training; however, further investigation is required to determine the mechanisms responsible for the improvement.
Ursina Arnet, Stefan van Drongelen, DirkJan Veeger and Lucas H. V. van der Woude
The aim of the study was to evaluate the external applied forces, the effectiveness of force application and the net shoulder moments of handcycling in comparison with handrim wheelchair propulsion at different inclines. Ten able-bodied men performed standardized exercises on a treadmill at inclines of 1%, 2.5% and 4% with an instrumented handbike and wheelchair that measured three-dimensional propulsion forces. The results showed that during handcycling significantly lower mean forces were applied at inclines of 2.5% (P < .001) and 4% (P < .001) and significantly lower peak forces were applied at all inclines (1%: P = .014, 2.5% and 4%: P < .001). At the 2.5% incline, where power output was the same for both devices, total forces (mean over trial) of 22.8 N and 27.5 N and peak forces of 40.1 N and 106.9 N were measured for handbike and wheelchair propulsion. The force effectiveness did not differ between the devices (P = .757); however, the effectiveness did increase with higher inclines during handcycling whereas it stayed constant over all inclines for wheelchair propulsion. The resulting peak net shoulder moments were lower for handcycling compared with wheelchair propulsion at all inclines (P < .001). These results confirm the assumption that handcycling is physically less straining.