Moderate exercise improves gait stability in disabled elders.

BACKGROUND Decreased muscle strength impedes elders' functional performance in daily activities such as gait. The mechanisms whereby increased strength improves gait are unknown. METHODS A prospective, blinded, randomized trial of moderate intensity strength exercise was conducted and its impact was measured on functional mobility during gait in 132 functionally limited elders. Lower extremity strength was measured, including hip abductor, hip extensor, and knee extensor strength. Of the 132 subjects, 120 subjects (mean age, 75.1 yrs) completed 6 months of elastic band resistance training at least 3 times a week or served as no-exercise controls. RESULTS Subjects increased their lower extremity strength in the exercise and control groups, by 17.6% and 7.3% (p < .01), respectively. Gait stability improved significantly more in the exercise group than in the control group (p < .05). Increases in forward gait velocity were not significantly different between groups. Peak mediolateral velocity and base of support improved in the exercise group, but not in the control group. Change in lower extremity strength correlated significantly but weakly with many of the gait variables. CONCLUSIONS Gait stability, especially mediolateral steadiness, improved in the exercise group but not in the control group. These results show that even moderate strength gains benefit gait performance in elders and thus provide a sound basis for encouraging low-intensity strength training for elders with functional limitations.

[1]  S R Lord,et al.  Physical activity program for older persons: effect on balance, strength, neuromuscular control, and reaction time. , 1994, Archives of physical medicine and rehabilitation.

[2]  G. Gehlsen,et al.  Falls in the elderly: Part II, Balance, strength, and flexibility. , 1990, Archives of physical medicine and rehabilitation.

[3]  L. Sperling,et al.  Evaluation of functional capacity in activities of daily living in 70-year-old men and women. , 1980, Scandinavian journal of rehabilitation medicine.

[4]  J. Judge,et al.  Balance improvements in older women: effects of exercise training. , 1993, Physical therapy.

[5]  Andrew M. Pope,et al.  COMMITTEE ON ASSESSING REHABILITATION SCIENCE AND ENGINEERING , 1997 .

[6]  S. Studenski,et al.  Is lower extremity strength gain associated with improvement in physical performance and disability in frail, community-dwelling elders? , 1998, Archives of physical medicine and rehabilitation.

[7]  C. Mulrow,et al.  Effects of Physical Therapy on Functional Status of Nursing Home Residents , 1993, Journal of the American Geriatrics Society.

[8]  L. Lipsitz,et al.  High-intensity strength training in nonagenarians. Effects on skeletal muscle. , 1990, JAMA.

[9]  P. Riley,et al.  Double-Blind, Placebo-Controlled Trial of Rehabilitation for Bilateral Vestibular Hypofunction: Preliminary Report , 1993, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.

[10]  B. Lateur,et al.  The Importance of Skeletal Muscle Strength to Physical Function in Older Adults , 1991, Annals of Behavioral Medicine.

[11]  E. Brandt,et al.  Enabling America: Assessing the Role of Rehabilitation Science and Engineering , 1997 .

[12]  H. Merrifield Exercise: It's Never Too Late , 1996 .

[13]  M. Tinetti,et al.  Systematic home-based physical and functional therapy for older persons after hip fracture. , 1997, Archives of physical medicine and rehabilitation.

[14]  J. Judge,et al.  Training Balance and Strength in the Elderly to Improve Function , 1993, Journal of the American Geriatrics Society.

[15]  Lester M. Wolfson,et al.  The Relationship of Knee and Ankle Weakness to Falls in Nursing Home Residents: An Isokinetic Study , 1987, Journal of the American Geriatrics Society.

[16]  J. Judge,et al.  Exercise to improve gait velocity in older persons. , 1993, Archives of physical medicine and rehabilitation.

[17]  E H Wagner,et al.  The effect of strength and endurance training on gait, balance, fall risk, and health services use in community-living older adults. , 1997, The journals of gerontology. Series A, Biological sciences and medical sciences.

[18]  M. E. Cress,et al.  The Seattle FICSIT/Movelt Study: The Effect of Exercise on Gait and Balance in Older Adults , 1993, Journal of the American Geriatrics Society.

[19]  C. Sherbourne,et al.  The MOS 36-Item Short-Form Health Survey (SF-36) , 1992 .

[20]  P. Riley,et al.  Biomechanical analysis of body mass transfer during stair ascent and descent of healthy subjects. , 1993, Journal of rehabilitation research and development.

[21]  J. Kehayias,et al.  The Boston FICSIT Study: The Effects of Resistance Training and Nutritional Supplementation on Physical Frailty in the Oldest Old , 1993, Journal of the American Geriatrics Society.

[22]  W. A. Hodge,et al.  Trunk kinematics during locomotor activities. , 1992, Physical therapy.

[23]  D. Pendergast,et al.  Maximal isometric torque of knee extension as a function of muscle length in subjects of advancing age. , 1990, Archives of physical medicine and rehabilitation.

[24]  M. Gossman,et al.  Balance performance, force production, and activity levels in noninstitutionalized men 60 to 90 years of age. , 1990, Physical therapy.

[25]  J A Ward,et al.  Balance, reaction time, and muscle strength in exercising and nonexercising older women: a pilot study. , 1993, Archives of physical medicine and rehabilitation.

[26]  L. Ferrucci,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. , 1997, The journals of gerontology. Series A, Biological sciences and medical sciences.

[27]  W. A. Hodge,et al.  Knee kinematics and kinetics during locomotor activities of daily living in subjects with knee arthroplasty and in healthy control subjects. , 1993, Physical therapy.