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 <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<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<0.001), slower gait speed (-0.247 SD units, p<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.

scholarly journals Motor and Physical Function Impairments in Middle-Aged and Older Adults in the Baltimore Longitudinal Study of Aging

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 232-232
Author(s):  
Yurun Cai ◽  
Qu Tian ◽  
Yuri Agrawal ◽  
Eleanor Simonsick ◽  
Jennifer Schrack
Keyword(s):  
Older Adults ◽  
Muscle Strength ◽  
Physical Function ◽  
Gait Speed ◽  
Standing Balance ◽  
Finger Tapping ◽  
Equation Modeling ◽  
Latent Factors ◽  
Lower Extremity Muscle ◽  
Mobility Difficulty

Abstract Older adults experience motor function decline early in the disablement process, impacting daily activities and contributing to adverse health outcomes. Few studies have comprehensively examined the interrelationships among motor and functional impairments and investigated whether their contributions to mobility difficulty vary in well-functioning older adults. We examined direct and indirect associations of motor and physical function impairments with slow gait speed (<1.0m/s) and mobility difficulty using structural equation modeling (SEM) among 858 participants aged ≥50 years in the BLSA (mean age=74.1±10.6, 55% women). Motor and physical function tests included grip strength, knee extension strength, proprioception, finger tapping, standing balance (semi-, full-tandem, single-leg), repeated chair stands, and usual gait speed. Mobility difficulty was defined as self-reported difficulty in walking ¼ mile or climbing stairs. Motor and physical function impairments increased linearly with age, with 27.6% of participants having slow gait speed and 10.4% having mobility difficulty. Age-adjusted SEMs identified chair stands pace as the strongest predictor of slow gait speed, followed by latent factors of upper and lower extremity muscle strength and standing balance. Chair stands pace was the strongest predictor of mobility difficulty, followed by gait speed. Latent factors of muscle strength, proprioception, finger tapping, and standing balance were indirectly associated with mobility difficulty via gait speed. All models showed good model fit (RMSEA<0.05, CFI>0.95). These findings suggest components of strength and balance are among the most important contributors to poorer functional performance in mid-to-late life. Future longitudinal studies gauging the effect of change in these factors are warranted.

scholarly journals Effectiveness of a community-delivered pneumatic machine resistance training programme (Gym Tonic) for older adults at neighbourhood senior centres – a randomized controlled trial

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Shuen Yee Lee ◽  
Alycia Goh ◽  
Ken Tan ◽  
Pei Ling Choo ◽  
Peck Hoon Ong ◽  
...  
Keyword(s):  
Older Adults ◽  
Resistance Training ◽  
Muscle Strength ◽  
Lower Extremity ◽  
Physical Function ◽  
Gait Speed ◽  
Intervention Group ◽  
Training Programme ◽  
Control Group ◽  
Lower Extremity Muscle

Abstract Background Resistance training with pneumatic machines attenuates the age-associated loss in muscle strength and function in older adults. However, effectiveness of scaled-up pneumatic machine resistance training in the community is not known. We evaluated the effectiveness of a multi-site community-delivered 12-week pneumatic machine resistance programme (Gym Tonic (GT)) on muscle strength and physical function in older adults. Methods Three hundred eighteen community-dwelling older adults aged ≥65 years were randomized into 12-week (twice/week) coach-supervised-community-based-GT-programme(n = 168) and wait-list control groups(n = 150). After 12 weeks, the intervention group continued with GT-training and the control group received supervised-GT-programme for further 12 weeks (partial-crossover-design). Fried frailty score, lower-extremity muscle strength and physical function (i.e., fast and habitual gait-speed, balance, repeated-chair-sit-to-stand, short physical performance battery (SPPB)) were determined at baseline, 12 and 24 weeks. Analysis adopted a modified-intention-to-treat-approach. Results After 12 weeks, lower-extremity muscle strength improved by 11–26%(all p < 0.05) and fast gait-speed improved by 7%(p = 0.008) in GT-intervention group(n = 132) than controls(n = 118), regardless of frailty status. Other physical function performance did not differ between control and intervention groups after 12 weeks (all p > 0.05). Frailty score improved by 0.5 in the intervention but not control group(p = 0.004). Within the intervention group, lower-extremity muscle strength and physical function outcomes improved at 24 weeks compared with baseline (all p < 0.001). Within controls, lower-extremity muscle strength, SPPB, repeated-chair-sit-to-stand and fast gait-speed improved post-GT (24-week) compared to both pre-GT (12-week) and baseline. Programme adherence was high in intervention [0–12-weeks,90%(SD,13%); 12–24-weeks,89%(SD,17%)] and control [12–24-weeks,90%(SD,19%)] groups. Conclusion Community-delivered GT resistance training programme with pneumatic machines has high adherence, improves muscle strength and fast gait-speed, and can be effectively implemented at scale for older adults. Future studies could examine if including other multi-modal function-specific training to complement GT can achieve better physical/functional performance in power, balance and endurance tasks. Trial registration ClinicalTrials.gov, NCT04661618, Registered 10 December 2020 - Retrospectively registered.

scholarly journals Long-term participation in community group exercise improves lower extremity muscle strength and delays age-related declines in walking speed and physical function in older adults

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Chisato Hayashi ◽  
Soshiro Ogata ◽  
Tadashi Okano ◽  
Hiromitsu Toyoda ◽  
Sonoe Mashino
Keyword(s):  
Older Adults ◽  
Muscle Strength ◽  
Physical Exercise ◽  
Lower Extremity ◽  
Physical Function ◽  
Community Dwelling ◽  
Group Exercise ◽  
Community Based ◽  
Lower Extremity Muscle

Abstract Background The effects of group exercise on the physical function of community-dwelling older adults remain unclear. The changes in lower extremity muscle strength, timed up and go (TUG) time, and the motor fitness scale (MFS), over time, among older adults who expressed a willingness to participate in community-based physical exercise groups, were determined using multilevel modelling. Methods We analyzed data of 2407 older adults between April 2010 and December 2019 from the registry of physical tests of community-based physical exercise groups. We conducted a retrospective cohort study to assess the effect of physical exercise on lower extremity muscle strength, TUG time, and MFS scores. The durations of the exercises were evaluated by frequency of physical test’s participate. Results A deterioration in lower extremity muscle strength was found in the short-term participant group only. However, in the mid-term and long-term participation groups, lower extremity muscle strength showed a trend of improvement. The TUG time and the MFS score were negatively correlated with increasing age in both groups divided by the duration of participation. However, there was a slower rate of deterioration in the long-term participation group. Discussion Lower extremity muscle strength, TUG time, and MFS scores decline with increasing age and there were differences in the slope of deterioration that depended on the duration of participation in community-based group exercise. Conclusion Participation in group exercise improved lower extremity muscle strength, TUG time, and MFS scores of older adults living in a community. The positive effects of group exercise were dependent on long-term participation.

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 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.

Pain, Lower-Extremity Muscle Strength, and Physical Function Among Older Mexican Americans

2005 ◽  
Vol 86 (7) ◽  
pp. 1394-1400 ◽  
Author(s):  
Soham Al Snih ◽  
Mukaila A. Raji ◽  
M. Kristen Peek ◽  
Kenneth J. Ottenbacher
Keyword(s):  
Muscle Strength ◽  
Lower Extremity ◽  
Physical Function ◽  
Mexican Americans ◽  
Lower Extremity Muscle

117 Study of Development and Validation of the Multi-Sensor based Kiosk Performing Short Physical Performance Battery Automatically

2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv28-iv33
Author(s):  
Heewon Jung ◽  
Jae-Young Lim ◽  
Jihong Park
Keyword(s):  
Older Adults ◽  
Physical Performance ◽  
Gait Speed ◽  
Physical Therapist ◽  
Short Physical Performance Battery ◽  
Standing Balance ◽  
Clinical Test ◽  
Chair Stand ◽  
Stand Test ◽  
Chair Stand Test

Abstract Background Short physical performance battery (SPPB) is a well-accepted clinical test to assess vulnerability in older adults. We aimed to develop and validate a multi-sensor based kiosk (e-SPPB kiosk) which can perform automated measurement for SPPB. Methods The e-SPPB kiosk was developed to measure 3 components of SPPB of standing balance, gait speed, and chair stand test with embedded sensors and algorithms. Feasibility and reliability of the e-SPPB kiosk was assessed with the manually measured SPPB (m-SPPB) by a physical therapist in participants aged 65 or older recruited from the outpatient rehabilitation clinic of the Seoul National University Bundang Hospital, Seongnam, Korea, from November 2018 to April 2019. Results In 34 participants with mean age of 73.6 (standard deviation [SD] 5.4), mean of e-SPPB total score was 10.1 (SD 2.2) and mean of m-SPPB total score was 10.2 (SD 2.3). Concordance between e-SPPB and m-SPPB total score was 0.94 (P&lt;0.001) and agreement by Kappa was 0.65 (P&lt;0.001). Agreements for components of e-SPPB and m-SPPB were 0.68 (P&lt;0.001), 0.73 (P&lt;0.001), 0.92 (P&lt;0.001) for standing balance, gait speed and chair stand test, respectively. Conclusion In older adults, physical performance measured by the e-SPPB kiosk correlated to m-SPPB measured by a single physical therapist. In multicenter studies for older people with physical performance as an outcome or selection criterion, e-SPPB kiosk can be used to reduce possible inter-rater variabilities of SPPB.

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