The purpose of this study was to pilot test a function-focused exercise intervention consisting of strength and gait-speed training in elders with reduced walking speed, decreased walking endurance, and functional impairment. Twelve participants, 77.2 years old (± 7.34), whose usual gait speed was <0.85 m/s, with walking endurance of <305 m in 5 min, and who were functionally impaired participated in a moderate-intensity exercise intervention. The training occurred 3 times per week, 75 min per session, for 3 months and combined 4 weeks of gait-speed training, walking exercise, and functional strengthening. The participants demonstrated mean usual gait speeds (≥1.0 m/s), endurance (≥350 m), and functional ability (≥10 score on performance battery) that were within normal limits after 12 weeks of training. Fastest gait speed (≥1.5 m/s) and muscle strength also improved significantly. Improvements were maintained during follow-up testing after 3–6 months. In summary, a 12-week intervention for frail, mobility-disabled participants led to improvements in walking, function, and strength.
Elizabeth J. Protas and Sandrine Tissier
Lorraine J. Phillips and Marcia Flesner
This qualitative study investigated individual and situational factors influencing physical activity (PA) practices of elders in residential-care/assisted-living (RC/ AL) communities. This article describes the results of focus-group interviews involving 47 residents across 6 RC/AL settings. Thematic analysis revealed 6 themes: staying active, past PA experiences, value of PA, barriers to PA, strategies to facilitate PA, and support needs to promote PA. Staying active meant walking indoors and out, attending chair-exercise programs, performing professionally prescribed home exercises, and using available exercise equipment. Past PA experiences shaped current preferences and practices. Participants agreed that exercise helped maintain physical functioning but recounted cognitive and situational barriers to PA. Lack of dedicated exercise space and short corridors hampered efforts to stay active. Participants wished for individualized home exercise programs and supervised exercise sessions. Future research should examine the extent to which the physical environment and PA programming in RC/AL communities affect elders’ PA.
Yong Tai Wang, Randy Bernard, Clint Cope, Li-Shan Chang, Weerawat Limroongreungrat and Stephen Sprigle
This study examined time efficiency in wheelchair locomotive activities among four different wheelchairs propelled by elders with arms and/or legs. Sixteen elder manual wheelchair users propelled her/his own wheelchair and three wheelchairs (the main drive-axis wheels positioning in front, middle, and rear, respectively) in the test of seven wheelchair locomotive activities of daily living. A Mixed-Model ANOVA and Bonferroni post hoc test (p < .05) were employed to determine the time efficiency among four wheelchairs and three groups. The results demonstrated better time efficiency resulted from propelling the mid drive-axis and/or rear drive-axis wheelchairs; using arms and legs simultaneously propelling wheelchairs was more time efficient than using the arms or legs only in the selected locomotive activities.
Mariane Fahlman, Amy Morgan, Nancy McNevin, Robert Topp and Debra Boardley
The purpose of the study was to determine whether resistance training (RT) or a combination of resistance and aerobic training (CT) resulted in the most improvement in measures of functional ability in functionally limited elders. Elderly adults who exhibited some limits in functional ability were randomly assigned to either a CT, RT, or control (C) group. Both RT and CT exercised three times per week for 16 weeks. At Weeks 0 and 17, participants completed six measures of strength and six functional tests. A 3 (group) × 3 (time) ANOVA with repeated measures on the time factor was used to analyze the results. CT and RT scored significantly better than C at Week 17 for biceps curl, elbow extension, chair stand, and time up the stairs. These findings demonstrate that RT and CT are both effective at increasing measures of strength and functional ability in elderly adults who begin exercise with functional limitations.
Ching-Yi Wang, Sharon L. Olson and Elizabeth J. Protas
The purposes of this study were to evaluate community-dwelling elderly adults with different levels of perceived mobility with 5 physical-performance tests, determine the cutoff values of the 5 tests, and identify the best tests for classifying mobility status. The community-mobility statuses of 203 community-dwelling elders were classified as able, decreased, or disabled based on their self-reported ability to walk several blocks and climb stairs. They also performed the functional reach, timed 50-ft walk, timed 5-step, timed floor transfer, and 5-min-walk endurance tests. We found in all tests that the “able” outperformed the “decreased” and that the “decreased” outperformed the “disabled,” except on the floor-transfer task. The optimum cutoff values of the 5 performance tests were also reported. The 5-min walk and timed 5-step test could best separate the “able” from the “decreased,” whereas the 50-ft-walk-test could best differentiate the “decreased” from the “disabled.” The results suggest that community-mobility function of older adults can be captured by performance tests and that the cutoff values of the 5-min-walk, 5-step, and 50-ft-walk tests can be used in guiding intervention or prevention programs.
Deborah F. Verfaillie, Jeanne F. Nichols, Ellen Turkel and Melbourne F. Hovell
The purpose of this study was to compare the effects of resistance training alone or in combination with balance and gait training on balance and gait measures in seniors. Subjects, ranging in age from 65 to 83 years, were randomly assigned to a strength and balance/gait group (SB, n = 21 ) or a control group (S, n = 18) receiving strength and relaxation training. Both groups significantly increased their strength and gait speed over the 12-week training period, but step length remained unchanged. The results suggest that elders can make significant gains in muscular strength and walking speed through resistance training, and that adding balance and gait training to resistance training can significantly improve some balance and gait measures beyond improvements achieved from strength training alone. If replicated, these results set the stage for investigations of injury control benefits possible from balance training.
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.
Ester Cerin, Anthony Barnett, Man-chin Cheung, Cindy H.P. Sit, Duncan J. Macfarlane and Wai-man Chan
This study examined reliability and validity of the Chinese version of the International Physical Activity Questionnaire–Long Form (IPAQ-LC) in Chinese seniors, including moderating effects of neighborhood walkability and socioeconomic status (SES) on reliability and validity. The IPAQ-LC was interviewer-administered (n = 96), accelerometer and 7-day walk-diary data were collected (n = 94), and the IPAC-LC was readministered (N = 92). Acceptable reliability was found for all measures of physical activity (PA) overall and across different types of neighborhood. Participants from highly walkable neighborhoods were more reliable at estimating walking for transport. Participants from low-SES areas were less reliable at estimating leisure-time PA and sitting but more reliable at estimating transport-related walking. IPAQ-LC walking was significantly related to light- but not moderate-intensity accelerometry-based PA. It was moderately to strongly related to a 7-day diary of walking. The data imply slow-paced walking, probably due to age, climate, and terrain. The findings suggest that the IPAQ-LC’s reliability and validity are acceptable in Chinese seniors.
George J. Salem, Man-Ying Wang and Susan Sigward
In order to obtain joint-specific baseline strength characteristics in older adults, clinicians and researchers must have knowledge regarding the relative stability of the various strength tests (the strength difference between repeated measures) and the number of prebaseline practice sessions required to obtain consistent data. To address these needs, the relative multiple-test stability and reliability associated with lower extremity isokinetic and 1-repetition-maximum (1RM) strength measures were assessed in a sample of older adults (N = 30, 65.2 ± 6.3 years), over 4 weeks (T1-T4). Isokinetic ankle plantar-flexion (30°/s) strength and 1RM ankle plantar-flexion, leg-press, and knee-flexion strength exhibited poor stability between Weeks T1 and T2 but stabilized between Weeks T2 and T3 and Weeks T3 and T4. The measures exhibited low incidence of injury and induced low levels of residual muscle soreness. Findings suggest that the 1RM measures require at least 1 prebaseline training session in order to establish consistent baseline performance and are more reliable than isokinetic ankle plantar-flexion tests.
Mariane M. Fahlman, Amy L. Morgan, Nancy McNevin, Debra J. Boardley and Robert Topp
The study investigated the effects of 16 weeks of exercise training on s-IgA in a population of low-functioning elderly. Forty-nine volunteers were randomly divided into 4 groups: strength training (ST), aerobic training (AT), a combination (CT), or control (C). ST demonstrated a significant increase in s-IgA from pre to post and a significant increase in the secretion rate from pre to mid and post. AT demonstrated a significant increase in s-IgA from pre to mid to post with no subsequent change in the secretion rate. There were no significant changes across time in CT or C, but C had consistently lower s-IgA values at post than did CT, ST, or AT, and the secretion rate was significantly higher in CT than C at mid and post. The results demonstrate that moderate exercise has a positive effect on mucosal immunity as measured by s-IgA in low-functioning elderly, suggesting a greater resistance to upper respiratory-tract infection with involvement in an exercise program.