Archives of Physical Medicine and Rehabilitation
Volume 89, Issue 12 , Pages 2278-2284 , December 2008

Which Impairments Are Most Associated With High Mobility Performance in Older Adults? Implications for a Rehabilitation Prescription

  • Jonathan F. Bean, MD, MS, MPH

      Affiliations

    • Departments of Physical Medicine and Rehabilitation and Medicine, Harvard Medical School, Boston, MA
    • Spaulding Rehabilitation Hospital, Boston, MA
    • Corresponding Author InformationReprint requests to Jonathan F. Bean, MD, MS, MPH Spaulding Cambridge Outpatient Center, 1575 Cambridge St, Box 9, Cambridge, MA 02138
    • ,
  • Dan K. Kiely, MA, MPH

      Affiliations

    • Hebrew Senior Life, Boston, MA
    • ,
  • Sharon LaRose, BS

      Affiliations

    • Spaulding Rehabilitation Hospital, Boston, MA
    • ,
  • Suzanne G. Leveille, PhD, RN

      Affiliations

    • Division of Primary Care, Beth Israel Deaconess Medical Center, Boston, MA

References 

  1. Morley JE. Mobility performance: a high-tech test for geriatricians. J Gerontol A Biol Sci Med Sci Aug. 2003;58:712–714
  2. Studenski S, Perera S, Wallace D, et al. Physical performance measures in the clinical setting. J Am Geriatr Soc Mar. 2003;51:314–322
  3. Guralnik JM, Ferrucci L, Pieper CF, et al. Lower extremity function and subsequent disability: consistency across studies, predictive models, and value of gait speed alone compared with the short physical performance battery. J Gerontol A Biol Sci Med Sci. 2000;55:M221–M231
  4. Guralnik JM, Simonsick EM, Ferucci L, et al. A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol. 1994;49:M85–M94
  5. Cavazzini C, Conti M, Bandinelli S, et al. Screening for poor performance of lower extremity in primary care: the Camucia Project. Aging Clin Exp Res. 2004;16:331–336
  6. Bandinelli S, Lauretani F, Boscherini V, et al. A randomized, controlled trial of disability prevention in frail older patients screened in primary care: the FRASI study (Design and baseline evaluation). Aging Clin Exp Res. 2006;18:359–366
  7. Verbrugge LM, Jette AM. The disablement process. Soc Sci Med. 1994;38:1–14
  8. Gill TM, Baker DI, Gottschalk M, et al. A prehabilitation program for physically frail community-living older persons. Arch Phys Med Rehabil. 2003;84:394–404
  9. Pahor M, Blair SN, Espeland M, et al. Life Study Investigators Effects of a physical activity intervention on measures of physical performance: results of the lifestyle interventions and independence for Elders Pilot (LIFE-P) study [erratum appears in J Gerontol A Biol Sci Med Sci 2007;62:337]. J Gerontol A Biol Sci Med Sci. 2006;61:1157–1165
  10. Bean J, Kiely DK, Herman S, et al. The relationship between leg power and physical performance in mobility-limited elders. J Am Geriatr Soc. 2002;50:461–467
  11. National Heart LaBI. Clinical guidelines in the identification, evaluation and treatment of overweight and obesity in adults. Bethesda: National Institutes of Health; 1998;
  12. Messier SP, Gutekunst DJ, Davis C, DeVita P. Weight loss reduces knee-joint loads in overweight and obese older adults with knee osteoarthritis. Arthritis Rheum. 2005;52:2026–2032
  13. Messier SP, Loeser RF, Miller GD, et al. Exercise and dietary weight loss in overweight and obese older adults with knee osteoarthritis: the Arthritis, Diet, and Activity Promotion Trial. Arthritis Rheum. 2004;50:1501–1510
  14. Miller GD, Rejeski WJ, Williamson JD, et al. The Arthritis, Diet and Activity Promotion Trial (ADAPT): design, rationale, and baseline results. Control Clin Trials. 2003;24:462–480
  15. Bean JF, Vora A, Frontera WR. Benefits of exercise for community-dwelling older adults. Arch Phys Med Rehabil. 2004;85(7 Suppl 3):S31–S42
  16. Folstein MF, Folstein SF, McHugh PR. “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. Psychiatr Res. 1975;12:189–198
  17. Radloff L, Lenore S. The CES-D scale: a self-reported depression scale for research in the general population. Applied Psychol Measurement. 1977;1:385–401
  18. Bean JF, Kiely DK, LaRose S, Alian J, Frontera WR. Is stair climb power a clinically relevant measure of leg power impairments in at-risk older adults?. Arch Phys Med Rehabil. 2007;88:604–609
  19. Callahan D, Phillips E, Carabello R, Frontera WR, Fielding RA. Assessment of lower extremity muscle power in functionally-limited elders. Aging Clin Exp Res. 2007;19:194–199
  20. Berg KO, Wood-Dauphinee SL, Williams JI, Maki B. Measuring balance in the elderly: validation of an instrument. Can J Public Health. 1992;83(Suppl 2):S7–S11
  21. Shumway-Cook A, Baldwin M, Polissar NL, Gruber W. Predicting the probability for falls in community-dwelling older adults. Phys Ther. 1997;77:812–819
  22. Bean JF, Kiely DK, Leveille SG, et al. The 6-minute walk test in mobility-limited elders: what is being measured?. J Gerontol Med Sci. 2002;57:M751–M756
  23. Pu CT, Johnson MT, Forman DE, et al. Randomized trial of progressive resistance training to counteract the myopathy of chronic heart failure. J Appl Physiol. 2001;90:2341–2350
  24. Borg G. Perceived exertion as an indicator of somatic stress. Scand J Rehab Med. 1970;2:92–98
  25. Bean JF, Leveille SG, Kiely DK, Bandinelli S, Guralnik JM, Ferrucci L. A comparison of leg power and leg strength within the InCHIANTI study: which influences mobility more?. J Gerontol Med Sci. 2003;58A:728–733
  26. Rantanen T, Guralnik JM, Ferrucci L, Leveille S, Fried LP. Coimpairments: strength and balance as predictors of severe walking disability. J Gerontol A Biol Sci Med Sci. 1999;54:M172–M176
  27. SAS. SAS/STAT User's Guide, Version 9.0. Cary: SAS Institute Inc; 2005;
  28. Fliess JL. The design and analysis of clinical experiments. New York: Wiley; 1986;
  29. Fiatarone-Singh MA. Exercise comes of age: rationale and recomendations for a geriatric exercise prescription. J Gerontol Med Sci. 2002;57A:M262–M282
  30. Rantanen T, Guralnik JM, Ferrucci L, et al. Coimpairments as predictors of severe walking disability in older women. J Am Geriatr Soc. 2001;49:21–27
  31. Sayers SP, Guralnik JM, Newman AB, Brach JS, Fielding RA. Concordance and discordance between two measures of lower extremity function: 400 meter self-paced walk and SPPB. Aging Clin Exp Res. 2006;18:100–106
  32. Shigematsu R, Rantanen T, Saari P, et al. Motor speed and lower extremity strength as predictors of fall-related bone fractures in elderly individuals. Aging Clin Exp Res. 2006;18:320–324
  33. Orr R, de Vos NJ, Singh NA, Ross DA, Stavrinos TM, Fiatarone-Singh MA. Power training improves balance in healthy older adults. J Gerontol A Biol Sci Med Sci. 2006;61:78–85
  34. National Institute on Aging. Exercise: a Guide from the National Institute in Aging. Bethesda: National Institute on Aging, National Institute of Health; 1999;
  35. Ferrucci L, Guralnik JM, Buchner D, et al. Departures from linearity in the relationship between measures of muscular strength and physical performance of the lower extremities: the Women's Health and Aging Study. J Gerontol A Biol Sci Med Sci. 1997;52:M275–M285
  36. Chan BK, Marshall LM, Winters KM, Faulkner KA, Schwartz AV, Orwoll ES. Incident fall risk and physical activity and physical performance among older men: the Osteoporotic Fractures in Men Study. Am J Epidemiol. 2007;165:696–703
  37. Weil E, Wachterman M, McCarthy EP, et al. Obesity among adults with disabling conditions. JAMA. 2002;288:1265–1268
  38. Houston DK, Ding J, Nicklas BJ, et al. The association between weight history and physical performance in the Health, Aging and Body Composition study. Int J Obes (Lond). 2007;31:1680–1687
  39. Lebrun CE, van der Schouw YT, de Jong FH, Grobbee DE, Lamberts SW. Fat mass rather than muscle strength is the major determinant of physical function and disability in postmenopausal women younger than 75 years of age. Menopause. 2006;13:474–481
  40. Sakari-Rantala R, Era P, Rantanen T, Heikkinen E. Associations of sensory-motor functions with poor mobility in 75- and 80-year-old people. Scand J Rehabil Med. 1998;30:121–127
  41. Manini TM, Visser M, Won-Park S, et al. Knee extension strength cutpoints for maintaining mobility. J Am Geriatr Soc. 2007;55:451–457
  42. Reuben DB, Seeman TE, Keeler E, et al. Refining the categorization of physical functional status: the added value of combining self-reported and performance-based measures. J Gerontol A Biol Sci Med Sci. 2004;59:1056–1061
  43. Alexander NB, Dengel DR, Olson RJ, Krajewski KM. Oxygen-uptake (VO2) kinetics and functional mobility performance in impaired older adults. J Gerontol A Biol Sci Med Sci. 2003;58:734–739
  44. Kerrigan DC, Todd MK, Della Croce U, Lipsitz LA, Collins JJ. Biomechanical gait alterations independent of speed in the healthy elderly: evidence for specific limiting impairments. Arch Phys Med Rehabil. 1998;79:317–322
  45. Leveille SG, Bean J, Ngo L, McMullen W, Guralnik JM. The pathway from musculoskeletal pain to mobility difficulty in older disabled women. Pain. 2007;128:69–77
  46. Skelton DA, Kennedy J, Rutherford OM. Explosive power and asymmetry in leg muscle function in frequent fallers and non-fallers aged over 65. Age Ageing. 2002;31:119–125
  47. Cuoco A, Callahan DM, Sayers S, Frontera WR, Bean J, Fielding RA. Impact of muscle power and force on gait speed in disabled older men and women. J Gerontol A Biol Sci Med Sci. 2004;59:1200–1206

 No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.

PII: S0003-9993(08)01487-1

doi: 10.1016/j.apmr.2008.04.029

Archives of Physical Medicine and Rehabilitation
Volume 89, Issue 12 , Pages 2278-2284 , December 2008

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