Dataset Information

Increased trunk extension endurance is associated with meaningful improvement in balance among older adults with mobility problems.

ABSTRACT:

Objective

To determine whether trunk extension endurance changes with training are associated with clinically meaningful improvements in balance among mobility-limited older adults.

Design

Longitudinal data from a randomized controlled trial.

Setting

Outpatient rehabilitation research center.

Participants

Community-dwelling older adults (N=64; mean age, 75.9y) with mobility limitations as defined by a score of 4 to 10 on the Short Physical Performance Battery.

Interventions

Sixteen weeks of progressive resistance training.

Main outcome measures

Outcomes were the Berg Balance Scale (BBS) and the Unipedal Stance Time (UST). Predictors included leg strength, leg power, trunk extension endurance, and the product of heart rate and blood pressure (RPP) at the final stage of an exercise tolerance test. We performed an analysis of data from participants who completed 16 weeks of training by using binary outcomes defined by a clinically meaningful change (CMC) from baseline to completion of the intervention (BBS=4 units; UST=5s). The association of predictor variables with balance outcomes was examined separately and together in multivariate adjusted logistic regression models.

Results

Trunk extension endurance in seconds (1.04 [1.00-1.09]) was independently associated with CMC on the BBS. Trunk extension endurance (1.02 [1.00-1.03]) was independently associated with CMC on the UST. Other physical attributes were not associated with meaningful change in balance.

Conclusions

Improvements in trunk extension endurance were independently associated with CMCs in balance in older adults. Leg strength, leg power, and RPP were not associated with CMC in balance. Poor trunk extension endurance may be a rehabilitative impairment worthy of further study as a modifiable factor linked to balance among older adults.

SUBMITTER: Suri P

PROVIDER: S-EPMC3124606 | biostudies-literature | 2011 Jul

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Increased trunk extension endurance is associated with meaningful improvement in balance among older adults with mobility problems.

Suri Pradeep P Kiely Dan K DK Leveille Suzanne G SG Frontera Walter R WR Bean Jonathan F JF

Archives of physical medicine and rehabilitation 20110602 7

<h4>Objective</h4>To determine whether trunk extension endurance changes with training are associated with clinically meaningful improvements in balance among mobility-limited older adults.<h4>Design</h4>Longitudinal data from a randomized controlled trial.<h4>Setting</h4>Outpatient rehabilitation research center.<h4>Participants</h4>Community-dwelling older adults (N=64; mean age, 75.9y) with mobility limitations as defined by a score of 4 to 10 on the Short Physical Performance Battery.<h4>Int ...[more]

PMID: 21636073

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Project description:BackgroundClinically meaningful changes in the five-repetition chair stand test are essential for monitoring mobility in integrated care for older people. Recommendations for the clinically meaningful change of the chair stand test are not well known. Our study aimed to estimate the absolute and relative clinically meaningful changes for older adults' five-repetition chair stand test.MethodsWe applied distribution-based and anchor-based methods in addition to receiver operator characteristics analyses to a population-based study of community-dwelling adults (SAGE Mexico study, n = 897) to derive the clinically meaningful change in the chair stand test. We used three self-reported clinical anchors: moving around, vigorous activities, and walking 1 km. Our primary outcome was the incidence of disability for basic activities of daily living (ADL). Secondly, we examined our estimates of clinically meaningful change in a clinical trial population of healthy volunteers (MAPT, France, study n = 1575) concerning the risk of incident ADL disability.ResultsThe age of SAGE Mexico participants ranged from 60 to 96 years; mean (SD) = 69.0 (6.2); 54.4% were female. Their baseline chair stand time averaged 12.1 s (SD = 3 s). Forty-eight participants (5.6%) showed incident disability over 3 years. The absolute and relative clinically meaningful change cut points found over 3 years of follow-up were 2.6 s and 27.7%, respectively. Absolute clinically meaningful change ranged from 0.5 to 4.7 s, depending on the estimation method. Relative clinically meaningful change ranged from 9.6 to 46.2%. SAGE Mexico participants with absolute and relative clinically meaningful declines (increasing 2.6 s and 27.7% from baseline time, respectively) showed an increased risk of ADL disability [aRR = 1.93; P = 0.0381; 95% CI (1.05, 3.46) and aRR = 2.27; P = 0.0157; 95% CI (1.22, 4.10)], respectively, compared with those without a clinically meaningful decline. MAPT participants [age range = 70-94; mean (SD) = 75.3 (4.4); 64.8% female; incident ADL disability over 5 years = 145(14.8%)] with a relative clinically meaningful decline (≥27.7% from baseline over 3 years) had a 74% higher risk of incident ADL disability than their counterparts [aHR = 1.74; P = 0.016; CI95% (1.11, 2.72); mean follow-up of 58 months].ConclusionsCommunity-dwelling older adults with an increase of 3 s or 28% in chair stand test performance over 3 years (approximately 1 s or 10% per year) could be the target of interventions to enhance mobility and prevent incident disability.

Dataset Information

Increased trunk extension endurance is associated with meaningful improvement in balance among older adults with mobility problems.

Objective

Design

Setting

Participants

Interventions

Main outcome measures

Results

Conclusions

Publications

Increased trunk extension endurance is associated with meaningful improvement in balance among older adults with mobility problems.

Similar Datasets

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