Self-management of mobility and fall risk might be possible if older adults could use a simple and safe self-test to measure their own mobility, balance, and fall risk at home. The aim of this study was to determine the safety, feasibility, and intraindividual reliability of the maximal step length (MSL), gait speed (GS), and chair test (CT) as potential self-tests for assessing mobility and fall risk. Fifty-six community-dwelling older adults performed MSL, GS, and CT at home once a week during a four-week period, wherein the feasibility, test-retest reliability, coefficients of variation, and linear mixed models with random effects of these three self-tests were determined. Forty-nine subjects (mean age 76.1 years [SD: 4.0], 19 females [42%]) completed the study without adverse effects. Compared with the other self-tests, MSL gave the most often (77.6%) valid measurement results and had the best intraclass correlation coefficients (0.95 [95% confidence interval: 0.91−0.97]). MSL and GS gave no significant training effect, whereas CT did show a significant training effect (p < .01). Community-dwelling older adults can perform MSL safely, correctly, and reliably, and GS safely and reliably. Further research is needed to study the responsiveness and beneficial effects of these self-tests on self-management of mobility and fall risk.
Kim T.J. Bongers, Yvonne Schoon, Maartje J. Graauwmans, Marlies E. Hoogsteen-Ossewaarde and Marcel G.M. Olde Rikkert
Mary Hellen Morcelli, Dain Patrick LaRoche, Luciano Fernandes Crozara, Nise Ribeiro Marques, Camilla Zamfolini Hallal, Mauro Gonçalves and Marcelo Tavella Navega
Mobility is an important functional condition in older adults, which requires good walking gait performance as it is essential to many daily activities. 1 – 3 A common gait speed criterion for identifying mobility limitation is the ability to walk at 1.22 m·s −1 , which is the walking speed
Karen L. Perell, Robert J. Gregor and A.M. Erika Scremin
The purpose of this study was to determine the effect of bicycle exercise on knee-muscle strength and gait speed in 8 male participants with cerebrovascular accident (CVA). Isokinetic knee-extensor and -flexor strength were measured in both concentric- and eccentric-contraction modes. Fifty-foot walking tests were used for gait speed. After only 4 weeks of stationary recumbent cycling (12 sessions), participants improved eccentric muscle strength of the knee extensors, bilaterally. Walking-speed improvements approached but did not achieve significance with training. Improvement in concentric muscle strength of the knee extensors was observed in the involved limb, although most participants demonstrated a nonsignificant increase in muscle strength in the contralateral limb, as well. No improvements were demonstrated in the knee-flexor muscles. Thus, bicycle exercise serves to improve knee-extensor strength. In addition, these strength improvements might have implications for better control of walking in terms of bilateral improvement of eccentric muscle strength.
Andreia S. P. Sousa and João Manuel R. S. Tavares
This study aims to assess the influence of gait speed (manipulated through cadence) on muscle activity patterns and activation degree during stance.
Thirtyfive healthy individuals participated in this study. Surface electromyographic activity from the gastrocnemius medialis (GM), gluteus maximus (GMax), biceps femoris (BF) and rectus femoris (RF) was acquired with subjects walking at three different speeds.
Speed influenced: (1) relative motor activity patterns at heel strike, midstance-propulsion transition and propulsion; (2) the activity level of RF, GMax, GM and BF, in decreasing order, with higher activity at the fastest and slowest speeds.
In general, muscle activity was higher at the fastest and slowest speeds than at the self-selected speed and only the activity of the main actions in each subphase remained stable. These findings suggest that gait speeds different from the self-selected speed influence not only activity levels but also relative muscle activity patterns. As a result, caution is advised when choosing standard speeds in gait studies, as this can lead to increased variability in relative muscle activity patterns.
Lisa Ferguson-Stegall, Mandy Vang, Anthony S. Wolfe and Kathy M. Thomsen
Falls are a major public health concern among older adults, and most occur while walking, especially under dualtask conditions. Jaques-Dalcroze eurhythmics (JDE) is a music-based movement training program that emphasizes multitask coordinated movement. A previous 6-mo JDE study in older people demonstrated improved gait and balance; however, the effects of short-term JDE interventions on fall risk-related outcomes are largely unknown. We conducted a preliminary investigation on whether a 9-week JDE intervention improved gait and stability in a community-dwelling older cohort, hypothesizing that improvements would occur in all outcome measures.
Nine participants (78.9 ± 12.3 y) completed the supervised JDE intervention (once/week for 60 min). Gait speed was determined by the 6-m timed walk test (6MTW); dual-task gait speed was determined by another 6MTW while counting backward from 50 aloud; and coordinated stability was assessed using a Swaymeter-like device.
Gait speed (0.92 ± 0.11 vs 1.04 ± 0.12 m/sec, P = .04) and dual-task gait speed (0.77 ± 0.09 vs 0.92 ± 0.11 m/sec, P = .0005) significantly improved.
This novel intervention is an effective short-term physical activity option for those that plan physical activity or fall-risk reduction programs for the older people.
Jordan M. Glenn, Jennifer Vincenzo, Collin K. Canella, Ashley Binns and Michelle Gray
Gait speed predicts survival in older adults; however, gait has not been evaluated in late middle-aged (LMA) populations.
Evaluate single- and dual-task gait speeds among sedentary (SED), recreationally active (RA), and masters athlete (MA) LMA adults.
Participants were SED (n = 20, age = 61.0 ± 5.8), RA (n = 57, age = 63.5 ± 8.4), and MA (n = 25, age = 57.5 ± 7.9). Two trials of each task (10 m) were completed: habitual speed (HS), maximal speed (MS), dual-task (counting backward from a number by 3) habitual speed (DT-HS), and dual-task maximal speed (DT-MS).
MA (2.08 ± 0.63 m/s) had significantly (p < .05) greater MS compared with SED (1.94 ± 0.30 m/s) and RA (1.99 ± 0.53 m/s). Similar differences existed for DT-MS (SED = 1.77 ± 0.32 m/s, RA = 1.80 ± 0.51 m/s, MA = 1.89 ± 0.63 m/s). MA had smaller MS and DT-MS changes (difference between MS and DT-MS speeds) compared with RA (12%) and SED (13%).
Maintaining a competitively active lifestyle increases MS in LMA adults and may support healthy aging.
Andrea L. Hergenroeder, Bethany Barone Gibbs, Mary P. Kotlarczyk, Subashan Perera, Robert J. Kowalsky and Jennifer S. Brach
, Mentis, & Kuber, 2018 ) or at controlled walking speeds ( Singh, Farmer, Van Den Berg, Killington, & Barr, 2016 ), which may be different than walking over ground at an individual’s usual, self-selected gait speed ( Watt et al., 2010 ). In addition, activity monitor validation studies in older adults
Theresa E. Gildner, J. Josh Snodgrass, Clare Evans and Paul Kowal
function has also been associated with future mortality and morbidity risk among older adults. Two common direct measures of physical function in study settings are grip strength (a good proxy of overall muscle condition and strength, measured using a dynamometer) and gait speed (timed walking speed over a
Silvia Aranda-García, Albert Busquets, Antoni Planas, Joan A. Prat-Subirana and Rosa M. Angulo-Barroso
Gait speed is related to physical function in older adults. This cross-sectional study examined the best predictors of maximal gait speed (MGS) among physical abilities, and general factors in healthy, rural community-dwelling older adults.
MGS, muscle strength, and postural sway were measured in 55 community-dwelling participants (age, 72.1 ± 6.8, range 61–87 years; 72.7% women). Two stepwise regressions were used to find MGS predictors in two models: physical abilities and global.
Strength of knee extensors with 60° of knee flexion (KStrength60°) and maximal distance in the anterior-posterior direction with eyes closed explained 50.2% of MGS variance (p < .05) in the physical abilities model. KStrength60°, age, and level of physical activity explained 63.9% of MGS variance (p < .05) in the global model.
Regardless of the model, KStrength60° was the best predictor of MGS in rural female older adults. Future research should examine the generalization of these findings to rural male older adults.
Ing-Mari Dohrn, Maria Hagströmer, Mai-Lis Hellénius and Agneta Ståhle
To describe objectively-measured physical activity levels and patterns among community-dwelling older adults with osteoporosis, impaired balance, and fear of falling, and to explore the associations with gait, balance performance, falls self-efficacy, and health-related quality of life (HRQoL).
Ninety-four individuals (75.6 ± 5.4 years) were included. Physical activity was assessed with pedometers and accelerometers. Mean steps/day, dichotomized into < 5,000 or = 5,000 steps/day, and time spent in different physical activity intensities were analyzed. Gait was assessed with a GAITRite walkway, balance performance was assessed with the modified figure-eight test and oneleg stance, falls self-efficacy was assessed with the Falls Efficacy Scale International, and HRQoL was assessed with Short Form-36.
Mean steps/day were 6,201 (991–17,156) and 40% reported < 5,000 steps/day. Participants with < 5,000 steps/day spent more time sedentary, had slower gait speed, poorer balance performance, and lower HRQoL than participants with ≥ 5,000 steps/day. No participants with < 5,000 met the recommended level of physical activity.