IMPLEMENTATION OF A COMMUNITY WALKING PROGRAM (WALK ON!) FOR FUNCTIONALLY-LIMITED OLDER ADULTS

2020 ◽  
pp. 1-7
Author(s):  
B.J. Nicklas ◽  
E.A. Chmelo ◽  
J. Sheedy ◽  
J.B. Moore
Keyword(s):  
Older Adults ◽  
Focus Group ◽  
Physical Function ◽  
Gait Speed ◽  
Assistive Device ◽  
Walking Ability ◽  
Mobility Limitations ◽  
Long Distance ◽  
Walking Program ◽  
Usual Gait Speed

Background: Walking interventions improve physical function, reduce fall risk, and prevent mobility disability—even in those with compromised walking ability. However, most prior studies have been conducted in controlled research settings, with no dissemination of an evidence-based walking program for older adults who have mobility limitations and/or are socially isolated. Objectives: This study reports data on the feasibility and acceptability of a community-based walking program (Walk On!) for older adults who are functionally limited, and assesses changes in physical function among attendees. The program sessions focused on long-distance walking, and took place for one-hour, for two days/week, and for 12 weeks at a time. Design: Pilot implementation study. Setting: Local church in Winston-Salem, NC. Participants: 49 program participants; Measurements: Physical function battery and satisfaction survey data, as well as formative evaluation data from six attendees of a focus group, are reported. Results: The majority of the participants were >75 years (71%), female (65%), and presented with low levels of physical function (usual gait speed=0.79±0.16; 30.6% used an assistive device). Satisfaction with the program was high (100% would recommend it to others) and focus group results were overwhelmingly positive. Mean attendance to scheduled sessions was 77%±21%, and 63% of participants attended at least 75% of scheduled sessions (n=8 attended 100%). On average, participants improved their 6-min walk distance by 8.9%, their SPPB score by 15.4%, their timed-up-go time by 9.0%, and their usual gait speed by 11.4%. Conclusion: The results of the initial evaluation of Walk On! show high feasibility and acceptability of the program, as well as efficacy for improving physical function. Further research is needed to evaluate a delivery method for wider implementation of the program and to definitively test its effectiveness for improving function and other health benefits.

scholarly journals Lung Function Reserve and Physical Function in Healthy Older Adults: Findings from BLSA

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 981-982
Author(s):  
Joey Saavedra ◽  
Ajoy Karikkineth ◽  
Luigi Ferrucci ◽  
Eleanor Simonsick
Keyword(s):  
Lung Function ◽  
Physical Function ◽  
Gait Speed ◽  
Functional Limitation ◽  
Later Life ◽  
Forced Expiratory Volume ◽  
Walking Ability ◽  
Mobility Limitations ◽  
Cross Sectional ◽  
Healthy Lung

Abstract Forced Expiratory Volume in 1-second (FEV1) that falls below the lower limit of normal (LLN) is a well-established correlate of functional limitation and disability. However, less is known about the functional implications of gradations of lung function above the LLN. We examined the cross-sectional association between gradations of healthy lung function and usual gait speed, reported walking ability, and fast 400m walk performance in 750 persons (50.7% men) aged 55-95 free from respiratory disease and mobility limitations, participating in the Baltimore Longitudinal Study of Aging (BLSA). The 2012 Global Lung Initiative (GLI) reference equations were used to calculate FEV1 Z-scores, with healthy lung function categorized as follows: -1.6 < Z ≤ -1.0 (pre-clinical), -1.0 < Z ≤ -0.3 (low normal), -0.3 < Z ≤ 0.3 (normal), 0.3 < Z ≤ 1.0 (high-normal), and Z > 1.0 (high). Associations between gradations of healthy lung function and physical function were evaluated using multivariate linear regression, adjusting for age, sex, height, weight, and waist circumference. Compared to the ‘pre-clinical’ category, the difference in 400m walk time was 0.71 (p>.05), -6.60 (p>.05), -12.21 (p<0.05), and -15.52 (p<0.01) seconds for the ‘low normal’, ‘normal’, ‘high-normal’, and ‘high’ categories, respectively. No associations between gradations of healthy lung function and normal gait speed or walking ability were found (p>0.05). Higher levels of lung function reserve are associated with better 400m walking performance, thus efforts to promote and/or reduce loss of lung function reserve may help individuals maintain high functional capacity in later life.

scholarly journals Does Poor Sleep Quality Predict Functional Limitations?

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 427-427
Author(s):  
Elliot Friedman ◽  
Elizabeth Teas
Keyword(s):  
Older Adults ◽  
Sleep Quality ◽  
Physical Function ◽  
Functional Capacity ◽  
Gait Speed ◽  
The United States ◽  
Self Report ◽  
Poor Sleep ◽  
Linear Regression Models ◽  
Mobility Limitations

Abstract Previous work from our group (Friedman, 2016) linked sleep complaints to declines in mobility and risk of incident limitations over a 9-10 year follow-up among middle-aged and older adults. While these results suggest that poor sleep might undermine functional capacity, the self-report nature of the data leaves the robustness of this association unclear. The current study addressed this uncertainty by examining links between sleep and mobility limitations using subjective and objective assessments of both. Data were from the Midlife in the United States (MIDUS) study: the biomarker sub-sample (N = 664) from the original cohort (collected 2004-2006) and the Refresher cohort (collected 2011-2013). Sleep was assessed using the Pittsburgh Sleep Quality Index (PSQI; subjective) and 7 consecutive days of actigraphy (objective). Functional capacity was assessed by self-report of limitations and measured gait speed, grip strength, and chair stands. In linear regression models adjusting for demographic and health factors, lower PSQI scores (better sleep quality) predicted fewer reported limitations, stronger grip, quicker gait, and faster chair stands (all p<.01). Of the objective sleep metrics, time to fall asleep and time spent awake during the night predicted more self-report limitations, weaker grip (latency only), and slower gait speed and chair stands. These results extend our prior work by showing a) subjective sleep is linked to measured as well as self-reported physical function, and b) objective assessments of sleep predict reduced physical function, albeit to a lesser extent. They also brighten the spotlight on sleep as a key health determinant in older adults.

scholarly journals 132 Physical Function Comparison of Acutely Unwell COVID-Negative Older Adults Pre-Pandemic and Through-Pandemic; “Covid-Protected”

2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i12-i42
Author(s):  
S Ritchie ◽  
C Snape ◽  
N Triteos ◽  
R Vamadevan ◽  
L Olesk ◽  
...  
Keyword(s):  
Older Adults ◽  
Mortality Rate ◽  
Hospital Mortality ◽  
Physical Function ◽  
Gait Speed ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Ethical Review ◽  
Short Period ◽  
Elderly Mobility

Abstract Introduction The risk of severe morbidity after COVID-19 infection is high in older adults (Lithander et al, 2020). Subsequent responsive UK Government guidance for older adults included self-isolation during the pandemic. It is therefore hypothesised that during the pandemic older adults are inadvertently deconditioned due to iatrogenic factors such as inactivity, social isolation, hospital-avoidance and malnutrition, and present with reduced resilience to illness and lower levels of function. The OPU continued to admit COVID-negative, or recently termed “COVID-protected”, patients throughout the pandemic. Data captured prior to, and during the COVID-19 pandemic has been compared to explore the implications on older adults, and elicit whether they are protected from the consequences of the pandemic? Method Demographic and physical function data (average 6 m gait-speed, Elderly Mobility Scale) were captured pre- and through-pandemic for all patients admitted to a COVID-negative OPU ward over a one month period. Ethical review was provided through local Trust governance process. Results Pre-pandemic 2019 (n = 67, mean(±SD) age 82.7(±8.2) years, 61%, hospital length-of-stay (LOS) 7.9(±7.3) days, hospital mortality-rate 7.2%) and through-pandemic 2020 (n = 73, 83.1(±8.3) years, 59%♀, LOS 9.0(±9.1) days, hospital mortality-rate 7.5%) data were captured during July 2019 and May 2020 respectively. There were no between-group differences in age [t(−.313) = 138, p = 0.755], gender [X2, 1 df, p = 0.782], LOS [t(0.78) = 134, p = 0.44], or hospital mortality-rate [X2 1 df, p = 0.96]. Through-pandemic patients had a significantly slower 6 m gait-speed (0.11(±0.05) m.s-1) than pre-pandemic (0.16(±0.24) m.s-1); [t(2.74) = 93, p = 0.007] and lower median (IQR) Elderly Mobility Scale (4(6 IQR) vs 9 (12 IQR) [u = 866, p = 0.015]). Conclusion Our data indicates this relatively short period of self-isolation might have significant implications on the physical function of older adults. The likely mechanism is iatrogenic deconditioning. Critical Public Health and policy responses are required to mitigate these unforeseen risks by deploying prehabilitative counter-measures and accurately targeted hospital and community rehabilitation.

scholarly journals Comparison of difficulty with activities of daily living in elderly adults undergoing hemodialysis and community-dwelling individuals: a cross-sectional study

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Toshiki Kutsuna ◽  
Yusuke Isobe ◽  
Takaaki Watanabe ◽  
Yusuke Matsunaga ◽  
Satomi Kusaka ◽  
...  
Keyword(s):  
Physical Function ◽  
Grip Strength ◽  
Gait Speed ◽  
Community Dwelling ◽  
Test Time ◽  
Control Group ◽  
Elderly Adults ◽  
Sit To Stand ◽  
Difficulty Score ◽  
Usual Gait Speed

Abstract Background Elderly adults undergoing hemodialysis (HD) have multiple comorbidities, physical frailty, and functional dependence with activities of daily living (ADL). ADL difficulty is an early predictor of ADL dependency in community-dwelling elderly adults. However, the characteristics of ADL difficulty in patients undergoing HD have not yet been reported. The present study aimed to examine the current status and characteristics of physical function and ADL difficulty in ambulatory elderly patients undergoing HD. Methods In all, 136 elderly outpatients undergoing HD and 40 community-dwelling controls participated in the present study. The characteristics, physical function (SARC-F score, grip strength, five-times sit-to-stand test time, usual gait speed, maximum gait speed, and short physical performance battery score), and scores from the ADL difficulty questionnaires [difficulty related to upper limb (U/L) and lower limb (L/L) functions] were compared between the HD and control groups. Multiple regression analysis was performed to examine whether the characteristics of physical function were able to discriminate ADL difficulty in the HD group. Results The HD group had a significantly greater SARC-F score, lower grip strength, longer five-times sit-to-stand test time, slower usual gait speed, slower maximum gait speed, lower short physical performance battery score, and lower U/L and L/L ADL difficulty scores compared to the control group (all P < 0.001). The distribution of U/L and L/L ADL difficulty scores showed a wider variation in the HD group than in the control group. The U/L ADL difficulty score was independently associated with the SARC-F score (β = −0.52, P < 0.001) and grip strength (β = 0.21, P = 0.02). The L/L ADL difficulty score was independently associated with the SARC-F score (β = −0.56, P < 0.001) and usual gait speed (β = 0.35, P < 0.001). Conclusions The elderly HD group had a poorer physical function and experienced stronger ADL difficulty than the control group. There was an association between ADL difficulty and sarcopenia or poor physical function among patients undergoing HD. These findings provide useful data for effective clinical management to prevent decline of ADL in ambulatory elderly patients undergoing HD.

scholarly journals Anthropometric indices predict physical function and mobility in older Australians: the Australian Longitudinal Study of Ageing

2002 ◽  
Vol 5 (5) ◽  
pp. 655-662 ◽  
Author(s):  
Elaine Bannerman ◽  
Michelle D Miller ◽  
Lynne A Daniels ◽  
Lynne Cobiac ◽  
Lynne C Giles ◽  
...  
Keyword(s):  
Older Adults ◽  
Body Weight ◽  
Longitudinal Study ◽  
Waist Circumference ◽  
Physical Function ◽  
South Australia ◽  
Self Report ◽  
Mobility Limitations ◽  
Australian Longitudinal Study ◽  
Increased Risk

AbstractObjective:To evaluate, in terms of function and mobility, the predictive value of commonly adopted anthropometric ‘definitions’ used in the nutritional assessment of older adults, in a cohort of older Australians.Design:Prospective cohort study – Australian Longitudinal Study of Ageing (ALSA).Setting:Adelaide, South Australia (1992–1994).Subjects:Data were analysed from 1272 non-institutionalised (685 males, 587 females) older adults ≥70 years old in South Australia. Seven ‘definitions’ commonly used in the anthropometric assessment of both under- and overnutrition (including four using body mass index (BMI), waist-to-hip ratio, waist circumference and percentage weight change) were evaluated at baseline, for their ability to predict functional and mobility limitation assessed (by self-report questionnaire) at two years follow-up. All questionnaires were administered and anthropometry performed by trained investigators. The associations between the definitions and decline in mobility and physical function were evaluated over two years using multiple logistic regression.Results:A BMI >85th percentile or >30 kgm−2 or a waist circumference of >102 cm in males and >88 cm in females increased risk of functional and mobility limitations. Over two years, a loss of 10% body weight significantly increased the risk of functional and mobility limitations.Conclusion:Maintaining weight within older adults, irrespective of initial body weight, may be important in preventing functional and mobility limitations. Excessive weight is associated with an increased risk of limitation in function and mobility, both key components of health-related quality of life.

scholarly journals Detectable Changes in Physical Performance Measures in Elderly African Americans

2010 ◽  
Vol 90 (6) ◽  
pp. 921-927 ◽  
Author(s):  
Kathleen Kline Mangione ◽  
Rebecca L. Craik ◽  
Alyson A. McCormick ◽  
Heather L. Blevins ◽  
Meaghan B. White ◽  
...  
Keyword(s):  
Older Adults ◽  
African American ◽  
Physical Performance ◽  
Performance Measures ◽  
Gait Speed ◽  
Intraclass Correlation ◽  
Assistive Device ◽  
Minimal Detectable Change ◽  
6Mwt Distance ◽  
African American Older Adults

Background African American older adults have higher rates of self-reported disability and lower physical performance scores compared with white older adults. Measures of physical performance are used to predict future morbidity and to determine the effect of exercise. Characteristics of performance measures are not known for African American older adults. Objective The purpose of this study was to estimate the standard error of measurement (SEM) and minimal detectable change (MDC) for the Short Physical Performance Battery (SPPB), Timed “Up & Go” Test (TUG) time, free gait speed, fast gait speed, and Six-Minute Walk Test (6MWT) distance in frail African American adults. Design This observational measurement study used a test-retest design. Methods Individuals were tested 2 times over a 1-week period. Demographic data collected included height, weight, number of medications, assistive device use, and Mini-Mental Status Examination (MMSE) scores. Participants then completed the 5 physical performance tests. Results Fifty-two participants (mean age=78 years) completed the study. The average MMSE score was 25 points, and the average body mass index was 29.4 kg/m2. On average, participants took 7 medications, and the majority used assistive devices. Intraclass correlation coefficients (ICC [2,1]) were greater than .90, except for the SPPB score (ICC=.81). The SEMs were 1.2 points for the SPPB, 1.7 seconds for the TUG, 0.08 m/s for free gait speed, 0.09 m/s for fast gait speed, and 28 m for 6MWT distance. The MDC values were 2.9 points for the SPPB, 4 seconds for the TUG, 0.19 m/s for free gait speed, 0.21 m/s for fast gait speed, and 65 m for 6MWT distance. Limitations The entire sample was from an urban area. Conclusions The SEMs were similar to previously reported values and can be used when working with African American and white older adults. Estimates of MDC were calculated to assist in clinical interpretation.

scholarly journals Cross-sectional associations of housework with cognitive, physical and sensorimotor functions in younger and older community-dwelling adults: the Yishun Study

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e052557
Author(s):  
Shuen Yee Lee ◽  
Benedict Wei Jun Pang ◽  
Lay Khoon Lau ◽  
Khalid Abdul Jabbar ◽  
Wei Ting Seah ◽  
...  
Keyword(s):  
Older Adults ◽  
Physical Function ◽  
Gait Speed ◽  
High Volume ◽  
Community Dwelling ◽  
Functional Health ◽  
Attention And Memory ◽  
Recreational Physical Activity ◽  
Cross Sectional ◽  
Sit To Stand

ObjectivesRegular moderate-to-vigorous intensity recreational physical activity (PA) improves physical and cognitive functions. However, the age-associated relationships between non-recreational PA and functional ability remain less explored. We examined the associations between housework and functional health among younger and older Singaporean community-dwelling adults.DesignCross-sectional study.Setting and participantsYounger (<65 years, n=249) and older (≥65 years, n=240) community-dwelling adults were randomly recruited from a large residential town in Singapore.Outcome measuresPhysical function was assessed using Short Physical Performance Battery (SPPB), repeated-chair-sit-to-stand and gait speed. Cognitive and sensorimotor functions were assessed using Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and Physiological Profile Assessment (PPA), respectively.MethodsLight housework (LH) and heavy housework (HH), recreational, and occupational and transport-related PAs were assessed using PA questionnaires. Participants were dichotomised into low-volume and high-volume LH and HH groups. Results were adjusted for level of recreational and other non-recreational PAs.ResultsAmong older but not younger adults, RBANS scores were 8% and 5% higher in high HH and LH groups compared with low HH and LH groups, respectively (p=0.012 and p=0.016). Specifically, HH was associated with 14% higher attention score (p=0.014), and LH was associated with 12% and 8% higher immediate and delayed memory scores, respectively (p<0.001 and p=0.004). In older adults, sit-to-stand time and PPA scores were 8% and 23% lower in the high HH group than the low HH group, respectively (p=0.011 and p=0.040). SPPB and gait speed did not differ with age or HH. LH was not associated with physical or sensorimotor function.ConclusionsAmong older adults, housework is associated with higher cognitive function, specifically in attention and memory. Associations of housework with physical function and sensorimotor performance were intensity dependent. Housework PA is positively associated with functional health among community-dwelling older adults, independent of recreation and other non-recreational PAs. Further longitudinal and intervention studies are needed to establish causality.

scholarly journals Resistance training improves mobility disability in community-dwelling older adults: a meta-analysis

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 904-904
Author(s):  
Christina Prevett ◽  
Kevin Moncion ◽  
Stuart Phillips ◽  
Julie Richardson ◽  
Ada Tang
Keyword(s):  
Older Adults ◽  
Resistance Training ◽  
Physical Function ◽  
Gait Speed ◽  
Positive Impact ◽  
Community Dwelling ◽  
Mobility Disability ◽  
Exercise Interventions ◽  
Walking Capacity ◽  
Community Dwelling Older Adults

Abstract Mobility disability is the impairment in function that affects the performance of daily tasks due to declines in physical function. Exercise interventions, particular resistance training, may have a positive impact on mobility disability, but the evidence for the effects of resistance training in older adults with mobility disability has not been previously systematically reviewed. This study was a systematic review of evidence related to resistance training on physical function for adults over 65 years of age with mobility disability. Four databases (PEDro, MedLine, Ovid, Web of Science) were searched from inception to February 2, 2021 for randomized controlled trials. Twenty-four articles from 22 studies (3,656 participants) were included in the review. Mean participant age ranged from 63-87 years and exercise interventions ranged from 10 weeks to 12 months in duration. Greater changes in 6-minute Walk Test (6MWT) distance (n=638, p&lt;0.0001; mean difference (MD) 16.1 metres; 95%CI 12.3-19.9), lower extremity strength (n=785, p&lt;0.0001; standard MD 2.01; 95%CI 1.27-2.75) and usual gait speed (n=2,106, p&lt;0.001; MD 0.05 metres/second, 95%CI 0.03-0.07) were seen with resistance training as compared to control. These results were maintained if resistance training was a sole intervention or a component of a multi-component program. Sensitivity analysis based on risk of bias concerns did not change results. This review demonstrates that resistance training improves walking capacity, strength and walking speed in community-dwelling older adults and may facilitate aging in place. Since improvements in strength and gait speed contribute to independence, our results indicate highly beneficial outcomes for older persons.

GRIP STRENGTH AND GAIT SPEED OF OLDER WOMEN RECEIVING PHYSICAL THERAPY IN A HOME-CARE SETTING

2014 ◽  
pp. 1-3
Author(s):  
R.W. BOHANNON
Keyword(s):  
Older Adults ◽  
Physical Therapy ◽  
Home Care ◽  
New England ◽  
Grip Strength ◽  
Older Women ◽  
Gait Speed ◽  
Care Setting ◽  
Vital Signs ◽  
Usual Gait Speed

Grip strength and gait speed have both been recommended as “vital signs” for older adults. I,therefore, sought to determine the extent to which grip strength and comfortable gait speed were limited andrelated in a sample of older women home-care patients. A retrospective analysis was conducted using archivedinitial therapy records of 33 older women (mean age = 80.7 years) residing in their homes in New England(USA). Demographics, bilateral grip strength and usual gait speed data were extracted from the records. Best gripstrength was 80.1% of its reference norm. Usual gait speed was 38.4% of its reference norm. Significantly morepatients were below reference norm for gait speed. Both measures were significantly less than functionalstandards as well. The measures were not correlated significantly. Grip strength and gait speed are sensitive tolimitations in older women home-care patients, but not equally so.

Motor and Physical Function Impairments as Contributors to Slow Gait Speed and Mobility Difficulty in Middle-Aged and Older Adults

2022 ◽  
Author(s):  
Yurun Cai ◽  
Qu Tian ◽  
Alden L Gross ◽  
Hang Wang ◽  
Jian-Yu E ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Lower Extremity ◽  
Physical Function ◽  
Gait Speed ◽  
Manual Dexterity ◽  
Standing Balance ◽  
Equation Modeling ◽  
Chair Stand ◽  
Usual Gait Speed ◽  
Mobility Difficulty

Abstract Background Motor function impacts ability to perform daily activities and maintain independence. Yet, the interrelatedness of upper and lower extremity motor impairments and the magnitude of their contribution to slow gait and mobility difficulty are not well investigated. Methods Participants in the Baltimore Longitudinal Study of Aging (N=728, aged 50-99) completed motor and physical function tests including grip and knee extension strength, pegboard, finger tapping, standing balance, chair stands, fast-paced 400m walk, and usual gait speed. Slow gait was defined as usual gait speed &lt;1.0m/s. Mobility difficulty was defined as self-reported difficulty walking ¼ mile or climbing stairs. Structural equation modeling (SEM) examined the interrelationships of motor measures and their contributions to slow gait and mobility difficulty, adjusting for demographics and comorbidities. Results Poorer manual dexterity (-0.571 standard deviation (SD) units, p&lt;0.001) and lower muscle strength (upper and lower extremity) (-0.447 SD units, p=0.014) were most strongly associated with slow gait speed, followed by slower chair stand pace (-0.195 SD units, p=0.002) and greater lap time variation (0.102 SD units, p=0.028). Lower muscle strength (-0.582 SD units, p=0.001) was most strongly associated with mobility difficulty, followed by slower chair stand pace (-0.322 SD units, p&lt;0.001), slower gait speed (-0.247 SD units, p&lt;0.001), and poorer standing balance (-0.190 SD units, p=0.043). Conclusions Components of manual dexterity and strength were the strongest correlates of slow gait and mobility difficulty in mid-to-late life. Longitudinal studies examining relationships between changes in these motor parameters and mobility are needed to elucidate possible causal effects.

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