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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.

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Ching-Yi Wang, Ming-Hsia Hu, Hui-Ya Chen and Ren-Hau Li

To determine the test–retest reliability and criterion validity of self-reported function in mobility and instrumental activities of daily living (IADL) in older adults, a convenience sample of 70 subjects (72.9 ± 6.6 yr, 34 male) was split into able and disabled groups based on baseline assessment and into consistently able, consistently disabled, and inconsistent based on repeat assessments over 2 weeks. The criterion validities of the self-reported measures of mobility domain and IADL-physical subdomain were assessed with concurrent baseline measures of 4 mobility performances, and that of the self-reported measure of IADL-cognitive subdomain, with the Mini-Mental State Examination. Test–retest reliability was moderate for the mobility, IADL-physical, and IADL-cognitive subdomains (κ = .51–.66). Those who reported being able at baseline also performed better on physical- and cognitive-performance tests. Those with variable performance between test occasions tended to report inconsistently on repeat measures in mobility and IADL-cognitive, suggesting fluctuations in physical and cognitive performance.

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Tao Chen, Kenji Narazaki, Yuka Haeuchi, Sanmei Chen, Takanori Honda and Shuzo Kumagai

Background:

This cross-sectional study was performed to examine associations of objectively measured sedentary time (ST) and breaks in sedentary time (BST) with instrumental activities of daily living (IADL) disability in Japanese community-dwelling older adults.

Methods:

The sample comprised 1634 older adults (mean age: 73.3 y, men: 38.4%). Sedentary behavior was measured using a triaxial accelerometer. Disability was defined as inability in at least 1 of the IADL tasks using the Tokyo Metropolitan Institute of Gerontology Index of Competence.

Results:

After adjusting for potential confounders and moderate-to-vigorous physical activity (MVPA), longer ST was significantly associated with higher likelihood of IADL disability, whereas a greater number of BST was associated with lower likelihood of IADL disability. ST and BST remained statistically significant after mutual adjustment with odds ratio of 1.30 (95% confidence interval [CI)], 1.00–1.70) and 0.80 (95% CI, 0.65–0.99), respectively.

Conclusions:

This study first demonstrated that shorter ST and more BST were associated with lower risk of IADL disability independent of MVPA and that the association for ST was independent of BST and vice versa. These findings suggest not only total ST but also the manner in which it is accumulated may contribute to the maintenance of functional independence in older adults.

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Fuzhong Li, Peter Harmer, Nicole L. Wilson and K. John Fisher

This study examined the effect of cobblestone-mat walking on health-related outcomes in older adults. Participants (mean age 72.6, N=40) were randomized into either an 8-week cobblestone-mat walking activity (n = 22) or a control group (n = 18). Cobblestone-mat walking entailed three 45-min sessions per week. Primary outcomes included SF-12 (mental, physical), instrumental activities of daily living (IADLs), psychophysical well-being, daytime sleepiness, and pain. Secondary outcomes included resting blood pressure and perceived control of falls. The walkers experienced significantly improved SF-12 scores, IADLs, and psychophysical well-being and significantly reduced daytime sleepiness and pain. They also reported significantly improved perceptions of control over falls. A significant between-groups difference in resting diastolic blood pressure was observed, with reductions in the walkers. A significant within-group reduction in systolic blood pressure was observed in the walkers only. The data indicate that cobblestone-mat walking can significantly improve health-related outcomes in older adults.

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Ching-Yi Wang, Ching-Fan Sheu and Elizabeth Protas

The purpose of this study was to test the construct validity of the hierarchical levels of self-reported physical disability using health-related variables and physical-performance tests as criteria. The study participants were a community-based sample of 368 adults age 60 years or older. These older adults were grouped into 4 levels according to their physical-disability status (able, mildly disabled, moderately disabled, and severely disabled groups) based on their self-reported measures on the mobility, instrumented activity of daily living (IADL), and activities of daily living (ADL) domains. Health-related variables (body-mass index, number of comorbidities, depression status, mental status, and self-perceived health status) and eight performance-based tests demonstrated significant group differences. Self-reported measures of physical disability can be used to categorize older adults into different stages of physical functional decline.

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Eeva Aartolahti, Sirpa Hartikainen, Eija Lönnroos and Arja Häkkinen

This study was conducted to determine the characteristics of health and physical function that are associated with not starting strength and balance training (SBT). The study population consisted of 339 community-dwelling individuals (75–98 years, 72% female). As part of a population-based intervention study they received comprehensive geriatric assessment, physical activity counseling, and had the opportunity to take part in SBT at the gym once a week. Compared with the SBT-adopters, the nonadopters (n = 157, 46%) were older and less physically active, had more comorbidities and lower cognitive abilities, more often had sedative load of drugs or were at the risk of malnutrition, had lower grip strength and more instrumental activities of daily living (IADL) difficulties, and displayed weaker performance in Berg Balance Scale and Timed Up and Go assessments. In multivariate models, higher age, impaired cognition, and lower grip strength were independently associated with nonadoption. In the future, more individually-tailored interventions are needed to overcome the factors that prevent exercise initiation.

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Kun Liang

well as the instrumental activities of daily living (IADL). The ADL included six items: eating, dressing, toileting, getting in and out of bed, bathing, and walking indoors. The IADL was measured by 10 items, including sweeping the floor, grocery shopping, cooking, washing clothes, lifting 10 kg

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Rachael C. Stone, Zina Rakhamilova, William H. Gage and Joseph Baker

–100%), with higher mean percentages indicating greater overall balance confidence. (d) The Lawton Instrumental Activities of Daily Living Scale (IADLs; Lawton & Brody, 1969 ; Cronbach’s alpha = .91) assesses the degree to which one is able to perform eight daily tasks necessary for independent living (i

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Christine E. Roberts, Louise H. Phillips, Clare L. Cooper, Stuart Gray and Julia L. Allan

, alongside instrumental activities of daily living (IADL) such as housework, managing money, and shopping for groceries. A loss of ADL ability is often associated with poorer quality of life ( Murakami & Scattolin, 2010 ) and increased strain on families and healthcare systems. Therefore, strategies designed

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Frances A. Kanach, Amy M. Pastva, Katherine S. Hall, Juliessa M. Pavon and Miriam C. Morey

for functional ambulation (e.g., Timed Up and Go [TUG] Functional Ambulatory Classification Score). Functional status includes self-reported measures of activities of daily living (ADL) and instrumental activities of daily living (IADL). Healthcare utilization comprises all measures of planned and