extremity and gait independence in stroke patients. We therefore aimed to clarify whether a gait analysis using an accelerometer could estimate gait independence in stroke patients. We expected that the evaluation of gait quality from RMS, gait regularity, and symmetry of the acceleration in the trunk and
Yoshifumi Kijima, Ryoji Kiyama, Masaki Sekine, Toshiyo Tamura, Toshiro Fujimoto, Tetsuo Maeda and Tadasu Ohshige
Katie J. Thralls and Susan S. Levy
Older adults are the fastest growing age demographic in the United States. The older adult population (≥ 65 years) is projected to increase by over 50% from 40.2 million in 2010 to 88.5 million by 2050 ( Vincent & Velkoff, 2010 ). During aging, maintaining independence is important, as is
Stephan Swinnen, Joost Vandenberghe and Erik Van Assche
This study sought to determine the relationships between the cognitive styles field dependence-independence and reflection-impulsivity and the acquisition of a gross motor skill in an unstructured learning environment. In reference to the first cognitive style construct, it was hypothesized that field-independent subjects perform better than field-dependent subjects because they provide organization when the material to be learned lacks structure, leading them to rely on their analyzing and restructuring ability. The second construct refers to cognitive inhibition required for response uncertainty tasks as well as motor impulse inhibition. Subjects (57 boys, 65 girls) were 13-year-old junior high school students. Several visual perceptual tests were administered and gymnastic performance scores were measured at pretest, during the learning session, and posttest. The hypothesis that field-independent subjects are more successful in an unstructured learning environment than field-dependent subjects was confirmed for boys only. The correlations between the reflection-impulsivity variables and gymnastic performance were generally low, and no support could be found for the hypothesis that reflective subjects are more successful in learning the skill than impulsive subjects.
Derek T. Smith, Stacey Judge, Ashley Malone, Rebecca C. Moynes, Jason Conviser and James S. Skinner
Reduced strength, balance, and functional independence diminish quality of life and increase health care costs. Sixty adults (82.2 ± 4.9 years) were randomized to a control or three 12-week intervention groups: bioDensity (bD); Power Plate (PP) whole-body vibration (WBV); or bD+PP. bD involved one weekly 5-s maximal contraction of four muscle groups. PP involved two 5-min WBV sessions. Primary outcomes were strength, balance, and Functional Independence Measure (FIM). No groups differed initially. Strength significantly increased 22–51% for three muscle groups in bD and bD+PP (P < .001), with no changes in control and PP. Balance significantly improved in PP and bD+PP but not in control or bD. bD, PP, and bD+PP differentially improved FIM self-care and mobility. Strength improvements from weekly 5-min sessions of bD may impart health/clinical benefits. Balance and leg strength improvements suggest WBV beneficially impacts fall risk and incidence. Improved FIM scores are encouraging and justify larger controlled trials on bD and bD+PP efficacy.
Edward M. Phillips, Jeffrey Katula, Michael E. Miller, Michael P. Walkup, Jennifer S. Brach, Abby C. King, W. Jack Rejeski, Tim Church and Roger A. Fielding
To examine baseline characteristics and change in gait speed and Short Physical Performance Battery (SPPB) scores in participants medically suspended (MS) from a physical activity intervention (PA).
Randomized controlled trial.
University and community centers.
Sedentary older adults (N = 213) randomized to PA in the Lifestyle Interventions and Independence for Elders Pilot (LIFE-P).
MS was defined as missing 3 consecutive PA sessions in adoption and transition phases or 2 wk in maintenance phase because of a health event.
In all, 122 participants completed PA without MS (NMS subgroup), 48 participants underwent MS and resumed PA (SR subgroup), and 43 participants underwent MS and did not complete PA (SNR subgroup). At baseline, SNR walked slower (p = .03), took more prescribed medications (p = .02), and had lower SPPB scores than NMS and SR (p = .02). Changes from baseline to Month 12 SPPB scores were affected by suspension status, adjusted mean (SE) SPPB change: SNR 0.0957 (0.3184), SR 0.9413 (0.3063), NMS 1.0720 (0.1871); p = .03.
MS participants unable to return to complete the PA in a trial of mobility-limited sedentary older adults had slower walking speeds, lower SPPB scores, and a higher number of prescribed medications at baseline. Change in SPPB scores at 12 months was related to suspension status.
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.
Tom Hazell, Kenji Kenno and Jennifer Jakobi
Aging leads to significant losses in muscle mass, strength, and the ability to independently perform activities of daily living (ADL). Typically, standard resistance training (RT) has been used to reduce these losses in function by maintaining or even increasing muscle strength in older adults. Increasing strength does not necessarily, however, result in an increase in the ability to perform ADL. There is now research suggesting that muscle power is more closely associated with the performance of ADL than muscle strength is, so training for muscle power might lead to more beneficial results in functional performance. This review of studies investigating the effect of training on ADL performance in older adults indicated that standard RT is effective in increasing strength in older adults, but power training that contains high-velocity contractions might be a more optimal means of training older adults when the emphasis is on increasing the performance of ADL.
Jessica C. Dobek, Karen N. White and Katherine B. Gunter
The purpose of this study was to determine the degree to which a novel training program based on activities of daily living (ADL) would affect performance of ADLs, as well as the fitness of older adults. Fourteen individuals (mean age 82 years) took part in a 10-week control period followed by a 10-week ADL-based training program. Pre- and posttests included the Physical Performance Test (PPT), the Physical Functional Performance–10 (PFP-10), and the Senior Fitness Test (SFT). After the training period, improvements ranging from 7% to 33% (p < .05) were seen on the PPT and PFP-10 and on three items of the SFT. After conversion to standard scores, the magnitude of change in the PPT and the PFP-10 was significantly greater (p < .05) than the magnitude of change in the SFT. These data support the idea that this novel ADL-based training program was able to facilitate improved performance of ADLs, as well as select measures of fitness among older adults.
Debra J. Rose
In recent years, a number of research investigations have been conducted in an effort to determine whether declining balance and mobility among older adults can be reversed or at least slowed. Unfortunately, the results of a number of these studies have not yielded positive outcomes. Three reasons are forwarded to account for these unsuccessful outcomes: the lack of a contemporary theory-based approach to the problem, the failure to use multiple and diverse measures of balance and mobility, and the failure to design multidimensional interventions that target the actual source(s) of the balance or mobility-related impairments. A model fall-risk-reduction program designed to address each of the shortcomings associated with previous research findings is presented. The program is group based and suitable for implementation in community-based and residential care facilities.
Joanna S. Kostka, Jan W. Czernicki and Tomasz J. Kostka
We assessed the relative association of quadriceps muscle strength and power as well as optimal shortening velocity (υopt) to physical functioning in 28 women aged 50–87 years with chronic osteoarthritis participating in a three-week multimodal exercise program. Quadriceps muscle strength, power, υopt, and functional performance using the Activities of Daily Living (ADL) scale, Timed Up & Go (TUG) test, Tinetti test, and 6-Minute Walking Test (6-MWT) were assessed pre- and postrehabilitation. With rehabilitation, patients improved the values of strength, power, and the results of all functional tests. Both at baseline and postrehabilitation, functional status was more strongly related to power and υopt than to strength. Functional gains obtained with rehabilitation were not related to changes in power or υopt, and only very modestly related to changes in strength. Future studies should assess the benefits and feasibility of power- and velocity-oriented training in patients with osteoarthritis.