Background: Isokinetic exercise is commonly used as a benchmark for strength and performance. Objective: The purpose of this investigation was to establish isokinetic fatigue test-retest reliability and examine the learning effect when testing without familiarization. Methods: 22 masters-aged [53±5 years), competitive female cyclists completed 3 separate 50-repetition knee flexion/extension tests on a Biodex, separated by one-week with no familiarization. Test-retest reliability [intra-class correlation [ICC]), 95% confidence intervals [CI), technical error of measurement [TEM) were calculated. Results: ICCs between trials exhibited excellent reliability during extension [.93–.97) and flexion [.93–.97) for all variables except time to peak torque [ICC=.35 and.45 for extension and flexion, respectively) and fatigue index [ICC=.47 for flexion). Relative TEM was minimal for extension between trial 1 and trial 2 [0.27%–0.97%) and between trial 2 and trial 3 [0.27%–1.45%) for all variables. Similar results were observed for flexion between trial 1 and trial 2 [0.87%–2.45%) and between trial 2 and trial 3 [0.54%–1.10%). No differences [Wilks Λ>.05) existed between trials, indicating no learning effect associated with the tests. Conclusions: There was strong test-retest reliability in masters-aged, female athletes and no learning effect was associated with the Biodex during a knee extension/flexion fatigue protocol.
Abstract Working with people with dementia (PWD) can be challenging even for the most seasoned health professionals. Hence, teaching health professional students how to effectively work with this patient population is of importance. Two cohorts (n=43; aged 23-36 years) of Graduate Physical Therapy students participated in multi-modal learning experiences geared towards working with PWD within a geriatrics course. Modules included: 1) online lectures and readings followed by a team based learning activity, 2) 3 hours of ‘positive approaches to care’ along with a simulated experience of performing Activities of Daily living and Instrumental Activities of Daily Living of PWD, and 3) one-on-one interactions during both lunch and dinnertime with at least three PWD residing in a state veteran’s home. The Dementia Attitudes Scale (DAS) was used to measure attitudes of students at baseline and following each activity. Repeated measures analysis of variance revealed a significant increase in positive attitudes of students working with PWD across each activity (98.2 +/- 10.5 baseline) with the most positive attitudes noted after interactions with PWD in a state veteran’s home (111.2 +/- 15.0), [F (2.0, 83.8) = 19.4, p < .01, partial eta^2 = .32]. However, this difference was not significant when controlling for students who had previous experience interacting with PWD . In conclusion, Doctor of Physical Therapy students’ attitudes towards PWD improve with different learning experiences, with the greatest improvements after one on one interactions with PWD if the student did not have prior experience interacting with PWD.
Background Despite the benefits of physical activity (PA), especially related to aging, physical therapists do not perform regular PA prescriptions secondary to various barriers, including lack of tools. Therefore, we developed the Inventory of Physical Activity Barriers (IPAB).Objective Explore potential solutions that could address the current lack of PA prescription among United States-based physical therapists treating patients 50 years and older.Method A convergent parallel mixed-method design consisting of focus groups and self-report questionnaires. Descriptive statistics were used for all quantitative variables. Focus groups were thematically coded.Results The 26 participants had 8.6 years (SD = 6.4) of clinical experience, 88.4% (n = 23) reported they regularly have PA conversations with patients, 65.4% (n = 17) regularly assess PA levels, and 19.2% (n = 5) regularly provide PA prescriptions. We identified three themes: 1) opportunities and challenges related to PA prescriptions; 2) lack of standardization in PA assessments and interventions; and 3) implementation potential for innovative solutions that address the current informal PA assessments and interventions.Conclusion Physical therapists are amenable to incorporating innovative solutions that support physical activity prescription behavior. Therefore, we recommend the continued development and implementation of PA assessment and prescription tools.
(1) Background: The purpose of this exploratory study was to describe variation in age of onset of functional limitations of Native Hawaiian and Pacific Islanders (NHPI) compared to other racial and ethnic groups. (2) Methods: Adults age 45 years and older who responded to the Functioning and Disability module within the 2014 National Health Interview Survey (NHIS) were included (n = 628 NHPI; 7122 non-Hispanic Whites; 1418 Blacks; 470 Asians; and 1216 Hispanic adults). The NHIS Functioning and Disability module included 13 items, which we organized into three domains of functional limitations using factor analysis: Mobility, Gross Motor Skills, and Fine Motor Skills. Responses were summed within each domain. (3) Results: After adjusting for age and sex, we found that racial/ethnic minority groups, with the exception of Asians, experience more functional limitations than Whites. Results further indicate that NHPI adults experienced an earlier surge in all three domains of functional limitations compared to other racial/ethnic groups. (4) Conclusions: These findings are novel and provide additional evidence to the existence of disparities in functional health outcomes across racial/ethnic groups. Future studies are needed to develop targeted and culturally tailored interventions for those most in need.
ABSTRACT In 2012, the Centers for Disease Control and Prevention (CDC) released STEADI (Stopping Elderly Accidents, Deaths and Injuries) toolkit which is based on the 2011 American Geriatrics Society/British Geriatrics Society (AGS/BGS) fall prevention guideline. In 2024, the National Network of Public Health Institutes (NNPHI), via a Cooperative Award with the CDC of the Department of Health and Human Services (HHS), invited AGS to recommend updates to STEADI with a focus on falls prevention in primary care. An AGS workgroup reviewed the 2022/2024 publications and held three outreach events with stakeholders (448 participants) to get feedback on current STEADI materials and draft recommendations focused on primary care. Recommendations for improving uptake of STEADI included reframing the why (alignment with ambulation goals) and the how (engage all available interdisciplinary team members) and addressing time limitations by prioritizing STEADI elements that can be done with available time and completing assessments across multiple visits. Screening recommendations included using the Three Key Questions first, and only if positive, asking the remaining Stay Independent questions. Assessment recommendations were to limit the scope of some activities (e.g., consider specifically fall risk‐increasing drugs) while expanding others (e.g., incorporating hearing and bladder health assessments). Where the choice of intervention is obvious from screening (e.g., referral to a physical therapist if screening questions points to a strength, mobility, or gait problem), an in‐office assessment may reasonably be skipped. These recommendations could improve effectiveness and ease of implementation of STEADI in primary care and help primary care teams reframe fall prevention as a chronic condition deserving ongoing engagement, assessment, intervention, and follow‐up.
The Centers for Disease Control and Prevention (CDC) Stopping Elderly Accidents, Deaths & Injuries (STEADI) toolkit is a national effort to prevent falls among older adults. Studies have been conducted on implementation of the STEADI, but no studies have investigated older adults’ adherence to or perceptions of fall prevention recommendations delineated within the STEADI algorithm. Semistructured interviews were conducted with a purposive sample of older adults 6 months after attending a falls risk assessment. Seventy-nine percent accurately recalled their fall risk, 57% followed one or more recommendations, and 32% did not recall at least one recommendation correctly. The most common recommendation recalled and adhered to was exercise. No participants recalled or adhered to recommendations including medication review, taking time changing positions, vision check, podiatrist visit, or physical therapy. Thirty-two percent fell. Of these, 55.6% did not follow any recommendations. Interview transcripts were analyzed using comparative methodology following the tenets of thematic analysis. Three themes emerged: participating in fall prevention, barriers to following recommendations, and providers can encourage people to prevent falls. An unexpected facilitator to participation in fall prevention efforts emerged—older adults’ perception that they were positively influencing society by participating in research and working with students and the university. This finding provides an opportunity for providers of health education to address the growing public health issue of falls among older adults while also creating opportunities for students to engage in community service and interdisciplinary service learning.
Prior work, primarily focusing on habitual gait velocity, has demonstrated a cost while walking when coupled with a cognitive task. The cost of dual-task walking is exacerbated with age and complexity of the cognitive or motor task. However, few studies have examined the dual-task cost associated with maximal gait velocity. Thus, this cross-sectional study examined age-related changes in dual-task (serial subtraction) walking at two velocities. Participants were classified by age: young-old (45-64 years), middle-old (65-79 years), and oldest-old (≥80 years). They completed single- and dual-task walking trials for each velocity: habitual (N = 217) and maximal (N = 194). While no significant Group × Condition interactions existed for habitual or maximal gait velocities, the main effects for both condition and age groups were significant (p < .01). Maximal dual-task cost (p = .01) was significantly greater in the oldest-old group. With age, both dual-task velocities decreased. Maximal dual-task cost was greatest for the oldest-old group.
Lower-body muscular power and movement velocity (MV) are associated with balance and physical function. The Tendo power analyzer (Tendo) is a portable device that calculates functional lower body power (FLBP) and MV. This reliable (Cronbach's α = .98) method is validated against motion capture analysis of functional lower body sit-to-stand power and velocity (r = .76). However, the Tendo has not been utilized in discrimination or prediction of falls. We determined the discriminant validity of FLBP and MV among older adults based on the history of falls. These results lay the framework for longitudinal research in FLBP and MV in fall prediction/prevention.Cross-sectional investigation examining differences between FLBP and MV during 5 sit-to-stands of 98 community-dwelling older adults (aged 77.5 years, 61% female) classified by the history of fall (no = 59, yes = 39). Participants completed 5 consecutive sit-to-stands (60-second rest between each) with FLBP and MV measured by the Tendo. Multivariate analysis of variance modeling determined between-group differences in functional lower body sit-to-stand average velocity, peak velocity, relative average power, and relative peak power. Binary and forward conditional logistic regression models determined the ability of each measure to discriminate fall history.FLBP and MV were significantly lower in older adults with a fall history (p < .05). Relative average power and peak power were 15% and 16% lower and average and peak velocity were 18% and 14% slower, respectively among fallers. Logistic regression indicated average velocity was the best discriminator of fall history (p < .05).The Tendo detects differences in FLBP and MV during a sit-to-stand while discriminating fall history. Future longitudinal studies should determine efficacy in fall prediction and applicability toward clinically relevant interventions for fall prevention.
'%3e%3cpath fill='%23012169' d='M0 0v30h60V0z'/%3e%3cpath stroke='%23fff' stroke-width='6' d='m0 0 60 30m0-30L0 30'/%3e%3cpath stroke='%23C8102E' stroke-width='4' d='m0 0 60 30m0-30L0 30' clip-path='url(%23b)'/%3e%3cpath stroke='%23fff' stroke-width='10' d='M30 0v30M0 15h60'/%3e%3cpath stroke='%23C8102E' stroke-width='6' d='M30 0v30M0 15h60'/%3e%3c/g%3e%3c/svg%3e)
