. There has been less focus on modifiable factors that may predict physical activity, such as reduced functional mobility, suboptimal balance confidence, and lack of prosthetic use. Identifying modifiable factors that influence physical activity is critical to reduce morbidity and mortality for adults
Jaclyn Megan Sions, Elisa Sarah Arch and John Robert Horne
Francisco Alvarez-Barbosa, Jesús del Pozo-Cruz, Borja del Pozo-Cruz, Antonio García-Hermoso and Rosa María Alfonso-Rosa
also differ when compared with older community-living people. Therefore, the aim of this project was to quantify the effect of WBV on balance, functional mobility, gait, functional performance, and quality of life in institutionalized older people by conducting a systematic review and meta-analysis of
Roger Ramsbottom, Anne Ambler, Janie Potter, Barbara Jordan, Alan Nevill and Carol Williams
Where strength training has been used in conjunction with functional-task training in older people, not only have there been improvements in leg strength but also improved function has been measured (e.g., Skelton & McLaughlin, 1996). Many studies use participants from care homes rather than community dwellers. We investigated changes in leg power, balance, and functional mobility in community-dwelling sedentary men and women over 70 years of age (n = 6 for training group [TR]; n = 10 for control group [CN]). Progressive training took place over 24 weeks using seated and nonseated exercise. For TR, leg power increased 40%, from 108 ± 40 to 141 ± 53 W (p < .01); dynamic balance increased 48%, from 22.3 ± 7.9 to 33.1 ± 6.1 cm (p < .01; functional reach); and functional mobility increased 12%, from 7.46 ± 1.32 to 6.54 ± 1.41 s (p < .05; timed walk). CN showed no significant change. In conclusion, a community-based exercise program led to large improvements in leg-extensor power, dynamic balance, and functional mobility.
Daisuke Uritani, Takahiko Fukumoto, Daisuke Matsumoto and Masayuki Shima
Evaluating toe flexor strength may be an important method for predicting and preventing walking dysfunction and falls, particularly among older adults. In this study, toe grip strength (TGS), the functional reach (FR, a measure of dynamic balance) test, the timed up and go (TUG) test (a measure of functional ability), isometric knee extension strength (IKES), sex, age, weight, and height were analyzed among 665 healthy Japanese older adults. Statistical analyses were used to assess the relationships between TGS and FR or TUG and to investigate whether TGS was independently associated with FR or TUG. Our results indicate that, among both men and women, TGS was associated with TUG, independent of age, height, weight, and IKES, but TGS was not associated with FR. These results may facilitate the development of strategies for improving functional mobility through physical therapy.
Silvia Varela, José M. Cancela, Manuel Seijo-Martinez and Carlos Ayán
each of the six functions. A score of six indicates full function, four indicates moderate dependence, and two or less indicates severe functional dependence. Timed “Up & Go” test The effects of the intervention on the participant’s functional mobility were assessed by means of the timed Up & Go test
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.
Debra J. Rose, C. Jessie Jones and Nicole Lucchese
The purpose of this study was to determine whether performance on the 8-ft up-and-go test (UG) could discriminate between older adult fallers (n = 71) and nonfallers (n = 63) and whether it would be as sensitive and specific a predictor of falls as the timed up-and-go test (TUG). Performance on the UG was significantly different between the recurrent faller and nonfaller groups (p < .01), as was performance on the TUG (p < .001). Older adults who required 8.5 s or longer to complete the UG were classified as fallers, with an overall prediction rate of 82%. The specificity of the test was 86% and the sensitivity was 78%. Conversely, the overall prediction rate for older adults who completed the TUG in 10 s or longer was 80%. The specificity of the TUG was 86% and the sensitivity was 71%.
Ecosse L. Lamoureux, Aron Murphy, Anthony Sparrow and Robert U. Newton
This study examined the effects of improved strength on an obstacle course (OC) simulating gait tasks commonly encountered by community-living older adults. Forty-five adults (mean age 68.2 ± 1.5 years) were randomly assigned to a control (10 women, 5 men) or an experimental group (EXP; 19 women, 10 men) and trained 3 days/week for 12 weeks. Using a 1-repetition-maximum (1-RM) method, 6 leg-strength measures were evaluated pre- and posttest. The times to walk an OC of 4 gait tasks (stepping over and across an obstacle, negotiating a raised surface, and foot targeting) set at 3 progressively challenging levels were also assessed. Significant Group × Time interactions were found on all 1-RM tests, with only EXP recording significant improvements (124–147%; p < .001). Strength gains in EXP were accompanied by significant improvements in the times to negotiate all gait stations and walk the entire OC (6-15%; p = .001–.014). This study showed that improving strength is an effective strategy to improve community locomotion, which might decrease the risks of falls in community-living older adults.
Juliana Hotta Ansai, Larissa Pires de Andrade, Paulo Giusti Rossi, Theresa Helissa Nakagawa, Francisco Assis Carvalho Vale and José Rubens Rebelatto
This study compared performances of timed up and go test subtasks between 40 older people with preserved cognition, 40 with mild cognitive impairment, and 38 with mild Alzheimer’s disease. The assessment consisted of anamneses and timed up and go test subtasks (sit-to-stand, walking forward, turn, walking back, and turn-to-sit). Data were captured by Qualisys Track Manager software and processed by Visual3D software. The MATLAB program was applied to detect and analyze timed up and go test subtasks. All subtasks differentiated people with Alzheimer’s disease and preserved cognition, except the sit-to-stand subtask, which did not distinguish any group. The walking forward subtask differed older people with preserved cognition from mild cognitive impairment, specifically on minimum peak of knee, average value of knee, and hip (pitch axis) during stance phase. The walking back, turn, and turn-to-sit subtasks distinguished subjects with Alzheimer’s disease from mild cognitive impairment. The separated analysis of transition and walking subtasks is important in identifying mobility patterns among cognitive profiles.
Talin Louder, Dennis Dolny and Eadric Bressel
Context: The aquatic environment provides a low-impact alternative to land-based exercise and rehabilitation in older adults. Objective: Evaluate the biomechanics of older adults and young adults performing jumping movements on land and in water. Design and Setting: Cross-sectional, mixed-factorial experiment; adjustable-depth pool at sports medicine research facility. Participants: Fifty-six young adults (age = 22.0 [3.9] y) and 12 healthy older adults (age = 57.3 [4.4] y). Interventions: Each participant performed 6 maximal effort countermovement jumps: 3 jumps were performed on land, and 3 other jumps were performed with participants immersed in chest-deep water. Main Outcome Measures: Using data from the amortization and propulsive phases of jumping, the authors computed the following kinetic and kinematic measures: peak and mean mechanical power, peak force, amortization time and rate, unweighting and propulsive times, and lower-extremity segment kinematics. Results: Mechanical power outputs were greater in younger adults (peak: 7322  W) versus older adults (peak: 5661.65 [2639.86] W) and for jumps performed in water (peak: 9387  W) versus on land (peak: 4545.84 [1356.53] W). Peak dorsiflexion velocities were greater for jumps performed in water (66  deg/s) versus on land (4  deg/s). The amortization rate was 26% greater in water versus on land. The amortization time was 20% longer in older adults versus young adults. Conclusions: Countermovement jumps performed in water are mechanically specific from those performed on land. Older adults jumped with longer unweighting times and increased mechanical power in water. These results suggest that aquatic-based exercise and rehabilitation programs that feature jumping movements may benefit older adults.