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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.

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Megan Babkes Stellino and Christina Sinclair

Thorough assessment of children’s physical activity is essential to efficacious interventions to reduce childhood obesity prevalence. The purpose of this study was to examine children’s recess physical activity (RPA) patterns of behavior using the Activities of Daily Living –Playground Participation (ADL-PP: Watkinson et al., 2001) instrument. ADL-PP-based RPA data from 3rd-5th grade schoolchildren (N = 444: 51% male, 23.6% overweight/obese) were analyzed to determine the number and specific activity patterns overall as well as according to gender and weightstatus. Patterns of RPA findings showed girls participated in a higher number of activities compared with boys who participated in more sport-related activities. A wide variety in the specific activities in which children engaged was found according to gender and weight-status. Examination of RPA, with the ADL-PP, extends the literature by providing new data relative to the variety and specific types of activities in which children choose to engage during discretionary times, such as recess.

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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.

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Wayne T. Phillips and William L. Haskell

The U.S. Department of Health and Human Services (1990) has specified as a key objective the reduction of disability in the performance of activities of daily living (ADL) for persons over the age of 65 years. Many ADL involve combinations of muscular strength, muscular endurance, and flexibility, three components that together have been referred to as "muscular fitness." The capacity of the elderly to remain functionally independent, therefore, may depend less on cardiovascular fitness, which has traditionally been the focus of health related fitness research, than on these components of muscular fitness. This review addresses the issue of muscular fitness and disability in the elderly by considering three questions: Is muscular fitness associated with ADL performance? Can muscular fitness be improved with exercise training? Do improvements in muscular fitness improve ADL performance? Answers to these questions will have important implications for future research and program implementation. Although initial findings are promising, more data are needed on the effect of muscular fitness on functional independence and quality of life in the elderly.

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Kazuo Inoue, Teiji Shono and Masatoshi Matsumoto

The primary objective of this study was to determine whether the absence of outdoor activities is associated with an increased risk of mortality among elderly people living at home. In January 1995, the authors enrolled 863 household residents, 65 years old and older, who were able to fully understand and complete a baseline interview unassisted. Participant demographics, functional capabilities, activities of daily living, and three dimensions of outdoor activities (initiative, transport, and frequency) were examined. Cohort mortality was assessed through December 1999. Of the 863 participants, 139 (16.1%) died within the study observation period. After adjusting for gender and age, three dimensions of functional impairment (vision, hearing, and speech), impairment in activities of daily living, and all three dimensions of outdoor activities were predictive of 5-year mortality. In multivariate analysis, these three dimensions remained as explanatory variables for mortality at 5 years. Assessment of outdoor-activity levels can help identify elderly individuals with greater mortality risk.

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Damien M. O’Meara and Richard M. Smith

The aim of this study was to compare the effects of grab rail position, orientation, and number of hands used on the kinetics of assisted sit-to-stand transfers. Participants were 12 able-bodied older adults between the ages of 69 and 88 years. While each one performed the sit-to-stand transfer, a motion analysis system with 9 cameras recording at 60 Hz tracked the 3-D trajectories of retroreflective markers. Bilateral 3-D platform, grab rail, and seat force data were collected at 200 Hz and normalized to participant body weight. Four lateral conditions were tested: vertical, 45° inclined, and horizontal with the hand placed at 150 mm and 400 mm forward of the seat front edge. Four anterior conditions were tested: vertical and horizontal orientations with the use of one hand and two hands. Posterior grab rail force increased with anterior assistance and with two-hand use compared to lateral assistance and single hand use, respectively. The selection of grab rail position and the number of hands incorporated during assistance also determined the symmetry of an-teroposterior net joint forces, net joint moments, and joint powers. Grab rail orientation determined the height of the gripping hand which influenced the assistance strategy. Grab rail position, orientation, and the amount of upper body contribution influenced the assisted sit-to-stand transfer. These kinetic responses to grab rail location require careful consideration in order to optimize grab rail assistance during the sit-to-stand transfer.

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Dahn Shaulis, Lawrence A. Golding and Richard D. Tandy

This study assessed the relative and absolute reliability of the five tests in the AAHPERD functional fitness assessment for men and women over 60 years of age. Twenty-eight apparently healthy subjects, ages 60 to 81, were tested three times during a 2-week period on each item in the test battery: sit and reach flexibility, body agility, coordination, strength/endurance, and half-mile walk. Relative reliability was assessed for both sexes via intraclass correlation coefficient. Absolute reliability was evaluated using repeated measures ANOVA. Intraclass correlations among sessions for men and women, respectively, were 0.97 and 0.98 for flexibility, 0.98 and 0.96 for body agility, 0.89 and 0.71 for coordination, 0.94 and 0.81 for strength/endurance, and 0.99 and 0.96 for the walk. Repeated measures ANOVAs with Tukey’s post hoc tests revealed improved performance from repeated practice sessions in all tests, although the improvement was not consistent between tests. Although the tests have high intraclass correlations, researchers using the test battery should include a random control group to assess the effects of training.

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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.

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Pia Laukkanen, Markku Kauppinen and Eino Heikkinen

Identifying predictors of functional limitations among the elderly is essential for planning and implementing appropriate preventive services. The purpose of this prospective study was to examine baseline physical activity as a predictor of health and functional ability outcomes 5 years later in people age 75 and 80 years at baseline. A clear trend was observed: The more physically active subjects had better health and functional ability compared to their more sedentary counterparts. After controlling for the baseline status, the degree of physical activity did not predict future disability but still maintained its predictive role at the level of disease severity. It is suggested that the level of habitual physical activity is an important predictor of health and functional ability among elderly people. Presumably, however, there is a reciprocal causal relationship between physical activity and health in elderly people. Physical activity counseling should therefore be included in preventive health strategies for the elderly.

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Diane Austrin Klein, William J. Stone, Wayne T. Phillips, Jaime Gangi and Sarah Hartman

The impact of proprioceptive neuromuscular facilitation (PNF) on physical function in assisted-living older adults (73-94 years old) was studied. A 5-week pretraining period consisting of weekly visits by trainers to participants preceded a 10-week training period of warm-up, PNF exercises, and cool-down. Training progressed from 1 set of 3 repetitions to 3 sets of 3 repetitions. Assessments were conducted at baseline (T1), postpretraining (T2), and posttraining (T3). Eleven of 14 volunteer participants completed the study. Physical function was assessed by range of motion (ROM), isometric strength, and balance and mobility measures. Repeated-measures ANOVA identified 6 measures (sit-to-stand, shoulder- and ankle-flexion ROM, and hip-extension, ankle-flexion, and ankle-extension strength) with statistically significant differences. With the exception of hip-extension strength, these measures were statistically significant from T2 to T3 in post hoc univariate tests. Results indicate that PNF flexibility training can improve ROM, isometric strength, and selected physical-function tasks in assisted-living older adults.