Document Detail

Which impairments are most associated with high mobility performance in older adults? Implications for a rehabilitation prescription.
MedLine Citation:
PMID:  19061739     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To test which rehabilitative impairments are associated with higher mobility performance among community-dwelling, mobility-limited older adults. DESIGN: Cross-sectional analysis of baseline data from participants within a randomized controlled trial. SETTING: Outpatient rehabilitation research center. PARTICIPANTS: Community-dwelling older adults (N=138; mean age, 75.4 y) with mobility limitations as defined by the Short Physical Performance Battery (SPPB). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Balance measured via the Berg Balance Scale, leg strength, leg velocity, submaximal aerobic capacity, body mass index (BMI), and mobility performance as measured by the SPPB. RESULTS: Each of the 5 physiologic attributes (unipedal balance, leg strength, leg velocity, submaximal aerobic capacity, BMI) was categorized into tertiles by using lower values as reference for impairment status. Within an adjusted model, measures associated with higher SPPB performance (>9) included a BBS score greater than or equal to 54 (odds ratio [OR]=4.54; 95% confidence interval [CI], 1.11-18.60), leg strength greater than or equal to 21.5 N/kg (OR=30.35; 95% CI, 5.48-168.09), leg velocity .0101 to .0129 m.s(-1).kg(-1) (OR=5.31; 95% CI, 1.25-22.57), and leg velocity greater than or equal to .0130 m.s(-1).kg(-1) (OR=22.86; 95% CI, 3.88-134.75). CONCLUSIONS: Our investigation highlights the importance of rehabilitative impairments in leg strength, leg velocity, and balance as being associated with mobility status as measured by the SPPB. In our sample of participants within an exercise trial, submaximal aerobic capacity and BMI status were not associated with mobility performance. These findings suggest that the augmentation of not only leg strength and balance but also leg velocity may be important in the rehabilitative care of mobility-limited older adults.
Jonathan F Bean; Dan K Kiely; Sharon LaRose; Suzanne G Leveille
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Archives of physical medicine and rehabilitation     Volume:  89     ISSN:  1532-821X     ISO Abbreviation:  Arch Phys Med Rehabil     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2008-12-08     Completed Date:  2009-01-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  2985158R     Medline TA:  Arch Phys Med Rehabil     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2278-84     Citation Subset:  AIM; IM    
Department of Physical Medicine, Harvard Medical School, Spaulding Rehabilitation Hospital, Boston, MA, USA.
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MeSH Terms
Cross-Sectional Studies
Disability Evaluation*
Exercise Test
Logistic Models
Mobility Limitation*
Multivariate Analysis
Muscle Strength
Postural Balance
Task Performance and Analysis*

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