Training Functional Ability in Old Age

doi:10.1016/S0031-9406(05)66916-7

Physiotherapy

Volume 82, Issue 3, March 1996, Pages 159-167

https://doi.org/10.1016/S0031-9406(05)66916-7 Get rights and content

Summary

The aims of this study were to determine the feasibility and acceptability of an exercise class run by health care professionals, and whether an eight-week period of moderate intensity exercise could improve the strength, flexibility, balance and selected functional abilities of women aged 74 years and over. Twenty women were matched for age and randomly assigned to either a control or a training group. At the end of the first eight-week period the control group undertook training.

Pre-and post-training measurements were obtained from nine women (median age 81 years) and pre-and post-control and post-training results obtained for nine women (median age 81 years). Strength, anthropometry, flexibility, balance and functional ability were measured.

Training comprised one supervised session (one hour) and two unsupervised home sessions (supported by an exercise booklet) per week for eight weeks. The training stimulus was one to three sets of four to eight repetitions of each exercise, using elastic tubing, tin cans or sponge balls for resistance. There were training-associated improvements of 9–55% in quadriceps and handgrip strength, flexibility, balance and selected tests of functional ability.

We conclude that repeated moderate intensity exercise which involves the practice of functional tasks and mobility can produce substantial increases in strength, balance, flexibility and selected tests of functional ability.

References (30)

YesavageJA et al.
‘Development and validation of a geriatric depression screening scale: A preliminary report’
Journal of Psychiatric Research
(1983)
AnianssonA et al.
‘Muscle function in 75-year-old men and women. A longitudinal study’
Scandinavian Journal of Rehabilitation Medicine
(1983)
BasseyEJ et al.
‘Leg extensor power and functional performance in very old men and women’
Clinical Science
(1992)
BinderEF et al.
‘Effects of a moderate intensity exercise program at reducing risk factors for falls in frail older adults’ (abstract)
Journal of the American Geriatric Society
(1991)
CrillyRG et al.
‘Effect of exercise on postural sway in the elderly’
Gerontology
(1989)
CsukaM et al.
‘Simple method for measurement of lower extremity muscle strength’
American Journal of Medicine
(1991)
DuncanPW et al.
‘Functional reach: A new clinical measure of balance’
Journal of Gerontology (Medical Sciences)
(1990)
FixAJ et al.
Human Activity Profile: Professional manual
(1988)
GrandjeanE
Ergonomics of the Home
(1973)
GreenH et al.
General Household Survey 1986
(1989)

GreigCA et al.

‘Exercise studies with elderly volunteers’

Age and Ageing

(1994)

IversonBD et al.

‘Balance performance, force production, and activity levels in non-institutionalized men 60 to 90 years of age’

Physical Therapy

(1990)

JudgeJO et al.

‘Balance improvements in older women: Effects of exercise training’

Physical Therapy

(1993)

KatzS et al.

‘Active life expectancy’

New England Journal of Medicine

(1983)

LawtonMP

‘The Philadelphia Geriatric Center morale scale: A revision’

Journal of Gerontology

(1975)

Cited by (89)

Do self-efficacy, body mass index, duration of onset and pain intensity determine performance on selected physical tasks in individuals with unilateral knee osteoarthritis?
2017, Musculoskeletal Science and Practice
Citation Excerpt :
Only the pain and function subscales were used in this study. Participants went through three functional tests namely: Stair test (Skelton and McLaughlin, 1996), Timed Up and Go test (Podsiadlo and Richardson, 1991; Kennedy et al., 2005) and 20-m walk test (Harrison, 2004). The tests were selected because they are time efficient, simple to perform with minimal instruction, require minimal staff training, and can be conducted within a clinical setting (Loudon et al., 2002).
To investigate the contributions of Pain Self-Efficacy (PSE), Function Self-Efficacy (FSE), Body Mass Index (BMI), duration of onset of Knee OsteoArthritis (KOA) and Present Pain Intensity (PPI) to performance on Stair Task Test (STT), Timed Up-and-Go (TUG) and 20-Meter Walk Test (20-MWT) and explore correlations among the variables in individuals with unilateral KOA.
Participants were 51 (22 male, 29 female) consecutively-selected patients with unilateral KOA. Participants' self-efficacy (PSE, FSE), and PPI were assessed using Arthritis Self-Efficacy Scale and Box Numerical pain scale respectively. Participants' performance on STT, TUG and 20-MWT was also assessed. Data were analyzed with Pearson product moment correlation and Stepwise linear regression at alpha level of 0.05.
Participants' mean age, duration of KOA onset and BMI were 52.18 ± 10.69 years, 30.29 ± 29.03months and 26.06 ± 3.86 kg/m² respectively. Participants' scores on 20MWT, TUG and STT had significant direct correlations with each other and with PPI while PPI had significant indirect correlations with PSE (r = −0.59) and FSE (r = −0.56). PSE had significant direct correlation (r = 0.65) with FSE. Both PSE and FSE had significant but low inverse correlations with scores on the performance tests. PPI explained about 43% or more of the variance in 20-MWT, TUG and STT. PPI and onset of KOA explained 62% of variance in 20-MWT while PPI and BMI jointly explained 60% of variance in TUG.
Though PSE and FSE significantly correlated with scores on the performance tests, PPI, duration of OA and BMI were the significant determinants of performance.
Evidence of detraining after 12-week home-based exercise programs designed to reduce fall-risk factors in older people recently discharged from hospital
2012, Archives of Physical Medicine and Rehabilitation
Citation Excerpt :
One could theorize that the introduction of more functional WB exercises would lead to a functional improvement that may translate to increased physical activity in an older person, even after the cessation of exercises, which may avoid detraining. There is some evidence of maintenance of benefits after cessation from group programs in frail people34 and also some evidence to support our hypothesis that task-specific functional exercises may translate into improved functional outcomes35,36; however, this has not previously been investigated in home-based programs in a post–hospital discharge population. A major conclusion of a recent meta-analysis was that exercise for fall prevention needs to be sustained over time,8 in that programs with doses of exercise that equate to a twice weekly program running over 25 weeks or more are likely to be more effective than lower-dose programs in preventing falls.8
Vogler CM, Menant JC, Sherrington C, Ogle SJ, Lord SR. Evidence of detraining after 12-week home-based exercise programs designed to reduce fall-risk factors in older people recently discharged from hospital.
To measure the extent to which improved sensorimotor function and balance resulting from a 12-week exercise intervention were retained 12 weeks after exercise cessation in older adults recently discharged from hospital.
Randomized controlled trial with reassessment 12 weeks after exercise cessation.
Home-based exercises.
Adults (N=180) aged 65 years and older recently discharged from hospital (mean length of stay, 12.3±10.6d).
Weight-bearing (WB) exercises (n=60), seated resistance (SR) exercises (n=60), or social visits (n=60).
Physiological Profile Assessment (PPA), a composite sensorimotor fall-risk score, and 2 measures of controlled leaning balance assessed at baseline, immediately after the intervention (12wk, 95% assessed), and again 12 weeks later (24wk, 92% assessed).
After the initial improvements in outcomes found at 12 weeks, both the SR and WB exercise groups showed detraining effects at 24 weeks. The PPA fall-risk scores for both SR and WB groups returned to close to baseline values, and there was no significant difference between groups at 24 weeks when controlling for baseline scores (P=.924). WB exercise participants lost up to half of the improvement in the maximal balance range and coordinated stability tests. There was no difference between groups for the maximal balance range test at 24 weeks when controlling for baseline scores (P=.207), but between-group differences were maintained for the coordinated stability test (P=.017).
Balance improvements and fall-risk reductions associated with a 12-week home-based exercise program in older adults were partially to totally lost 12 weeks after the cessation of the intervention. These significant detraining effects suggest that sustained adherence to falls prevention exercise programs is required to reduce fall risk.
Rehabilitation: Therapy Techniques
2010, Brocklehurst's Textbook of Geriatric Medicine and Gerontology
Functional training with blood occlusion influences muscle quality indices in older adults
2020, Archives of Gerontology and Geriatrics
Citation Excerpt :
Regular resistance training reduces the negative neural and musculoskeletal changes associated with aging. However, mobility-specific exercises appears to produce greater improvements in functional outcomes than traditional resistance training in older adults (Skelton & McLaughlin, 1996). Hence, functional training (FT) which combines resistance training and mobility exercises appears to be an ideal training regimen for elder population.
This study aimed to determine if functional training with blood flow restriction (BFR) has a greater effect on muscle quality indices and performance of older men when compared to functional training without BFR.
Thirty men (67.7 ± 5.8 years) were randomly assigned to one of the following three groups: functional training (FT), functional training with blood flow restriction (FTBFR), and control (C). Participants in both experimental groups trained three sessions per week for six weeks. The training program included eleven body exercises, which were performed in 2–4 sets of 10 repetitions. FTBFR group wore pneumatic cuffs on their extremities that begun with 50 % of estimated arterial occlusion pressure and increased by 10 % every 2 weeks. Before and after the intervention period, subjects completed a series of tests to assess physical performances along with changes serum muscle quality indices.
A significant decrease in serum C-terminal Agrin Fragment (CAF) levels were observed in FT and FTBFR groups (p ≤ 0.05). In addition, the levels of CAF in FTBFR group was significantly lower compared to control group. Moreover, the circulatory levels of N-terminal propeptide type III collagen (P3NP) were reduced significantly in FT and C groups (p ≤ 0.05) but did not statistically differ from baseline in FTBFR group (p > 0.05). These changes were accompanied by significant improvements in dynamic strength, flexibility, static, and dynamic balance in both training groups (p ≤ 0.01).
The finding showed greater improvements in muscle quality indices and functional performance of older men when exercises performed with BFR.
Classification of static postures with wearable sensors mounted on loose clothing
2023, Scientific Reports
Effects of different strength training intensities on health-related parameters towards engaging in physical activity in elderly
2022, Cultura, Ciencia y Deporte

View all citing articles on Scopus

¹: Dawn A Skelton PhD BSc is a research fellow in the Institute of Human Performance University College London.

²: Ann W McLaughlin MCSP is a physiotherapist in private practice at 1B Florence Road, London W5 3TU.

View full text

Article preview

Physiotherapy

Summary

References (30)

‘Development and validation of a geriatric depression screening scale: A preliminary report’

Journal of Psychiatric Research

‘Muscle function in 75-year-old men and women. A longitudinal study’

Scandinavian Journal of Rehabilitation Medicine

‘Leg extensor power and functional performance in very old men and women’

Clinical Science

‘Effects of a moderate intensity exercise program at reducing risk factors for falls in frail older adults’ (abstract)

Journal of the American Geriatric Society

‘Effect of exercise on postural sway in the elderly’

Gerontology

‘Simple method for measurement of lower extremity muscle strength’

American Journal of Medicine

‘Functional reach: A new clinical measure of balance’

Journal of Gerontology (Medical Sciences)

Human Activity Profile: Professional manual

Ergonomics of the Home

General Household Survey 1986

‘Exercise studies with elderly volunteers’

Age and Ageing

‘Balance performance, force production, and activity levels in non-institutionalized men 60 to 90 years of age’

Physical Therapy

‘Balance improvements in older women: Effects of exercise training’

Physical Therapy

‘Active life expectancy’

New England Journal of Medicine

‘The Philadelphia Geriatric Center morale scale: A revision’

Journal of Gerontology

Cited by (89)

Do self-efficacy, body mass index, duration of onset and pain intensity determine performance on selected physical tasks in individuals with unilateral knee osteoarthritis?

Evidence of detraining after 12-week home-based exercise programs designed to reduce fall-risk factors in older people recently discharged from hospital

Rehabilitation: Therapy Techniques

Functional training with blood occlusion influences muscle quality indices in older adults

Classification of static postures with wearable sensors mounted on loose clothing

Effects of different strength training intensities on health-related parameters towards engaging in physical activity in elderly

RESEARCH REPORTTraining Functional Ability in Old Age

Summary

Journal of Psychiatric Research

‘Muscle function in 75-year-old men and women. A longitudinal study’

Scandinavian Journal of Rehabilitation Medicine

‘Leg extensor power and functional performance in very old men and women’

Clinical Science

‘Effects of a moderate intensity exercise program at reducing risk factors for falls in frail older adults’ (abstract)

Journal of the American Geriatric Society

‘Effect of exercise on postural sway in the elderly’

Gerontology

‘Simple method for measurement of lower extremity muscle strength’

American Journal of Medicine

‘Functional reach: A new clinical measure of balance’

Journal of Gerontology (Medical Sciences)

Human Activity Profile: Professional manual

Ergonomics of the Home

General Household Survey 1986

‘Exercise studies with elderly volunteers’

Age and Ageing

‘Balance performance, force production, and activity levels in non-institutionalized men 60 to 90 years of age’

Physical Therapy

‘Balance improvements in older women: Effects of exercise training’

Physical Therapy

‘Active life expectancy’

New England Journal of Medicine

‘The Philadelphia Geriatric Center morale scale: A revision’

Journal of Gerontology

RESEARCH REPORT
Training Functional Ability in Old Age