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M Elaine Cress

Publications and source records attributed to M Elaine Cress.

12 recordsLinked to original sources

A comparison of physical functional performance and strength in women with fibromyalgia, age- and weight-matched controls, and older women who are healthy.

BACKGROUND AND PURPOSE: The purpose of this study was to compare functionality and strength among women with fibromyalgia (FM), women without FM, and older women. SUBJECTS: Twenty-nine women with FM (age [X+/-SD]=46+/-7 years), 12 age- and weight-matched women without FM (age=44+/-8 years), and 38 older women who were healthy (age=71+/-7 years) participated. METHODS: The Continuous Scale-Physical Functional Performance Test (CS-PFP) was used to assess functionality. Isokinetic leg strength was measured at 60 degrees/s, and handgrip strength was measured using a handgrip dynamometer. RESULTS: The women without FM had significantly higher functionality scores compared with women with FM and older women. There were no differences in functionality between women with FM and older women. Strength measures for the leg were higher in women without FM compared with women with FM and older women, and both women with and without FM had higher grip strengths compared with older women. DISCUSSION AND CONCLUSION: This study demonstrated that women with FM and older women who are healthy have similar lower-body strength and functionality, potentially enhancing the risk for premature age-associated disability.

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Best practices for physical activity programs and behavior counseling in older adult populations.

Physical activity offers one of the greatest opportunities for people to extend years of active independent life and reduce functional limitations. The article identifies key practices for promoting physical activity in older adults, with a focus on those with chronic disease or low fitness and those with low levels of physical activity. Key practices identified: (a) A multidimensional activity program that includes endurance, strength, balance, and flexibility training is optimal for health and functional benefits; (b) principles of behavior change including social support, self-efficacy, active choices, health contracts, assurances of safety, and positive reinforcement enhance adherence; (c) manage risk by beginning at low intensity but gradually increasing to moderate physical activity, which has a better risk:benefit ratio and should be the goal for older adults; (d) an emergency procedure plan is prudent for community-based programs; and (e) monitoring aerobic intensity is important for progression and motivation. Selected content review of physical activity programming from major organizations and institutions is provided.

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Continuous-scale physical functional performance test: validity, reliability, and sensitivity of data for the short version.

BACKGROUND AND PURPOSE: The Continuous-Scale Physical Functional Performance Test (CS-PFP) can be used to obtain valid, reliable, and sensitive measurements of physical functional capacity. This test requires a fixed laboratory space and approximately 1 hour to administer. This study was carried out in 4 steps, or substudies, to develop and validate a short, community-based version (PFP-10) that requires less space and equipment than the CS-PFP. SUBJECTS AND METHODS: Retrospective data (n=228) and prospective data (n=91) on men and women performing the CS-PFP or the PFP-10 are reported. A 12-week exercise program was used to examine sensitivity to change. Data analyses were done using paired t-test, Pearson correlation, intraclass correlation coefficient (ICC), and delta index (DI) procedures. RESULTS: The PFP-10 total score and 4 of the 5 domain scores were statistically similar (within 3%) to those of the CS-PFP. The PFP-10 upper-body strength domain score was 17% lower, but was highly correlated (ICC=.97). Community and established laboratory PFP-10 scores were similar (ICC=.85-.97). The PFP-10 also is sensitive to change (DI=.21-.54). DISCUSSION AND CONCLUSION: The PFP-10 yields valid, reliable, and sensitive measurements and can be confidently substituted for the CS-PFP.

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Leg extensor power, cognition, and functional performance in independent and marginally dependent older adults.

BACKGROUND: physical and cognitive function must be integrated and optimised in performance of daily activities. Age-related loss of physical function can result in poor performance of necessary daily activities and possibly lead to increased dependency and a change of living status. OBJECTIVES: (1) to evaluate average differences in physiological, cognitive, and functional performance of older adults from two different levels of independence, (2) to examine contributions of leg power, cognition, and functional performance to level of independence. DESIGN: cross-sectional study of self-reported 'independent' versus 'marginally dependent' older adults. SUBJECTS: 35 older adults (77.2 +/- 6 years) were placed into independent (n = 18) or marginally dependent (n = 17) groups based upon the Medical Outcomes Study SF36 physical function scores (independent: SF36PF > or = 85, marginally dependent: SF36PF < 85) and living status. METHODS: assessment of physical function includes the dependent variable, SF36PF. Assessment of physical, cognitive, and functional performance include the independent variables of leg extensor power, reaction time, processing speed, memory, attention, and functional performance. Functional performance is assessed by the Continuous Scale Physical Functional Performance Test. RESULTS: independent older adults have greater performance on leg power, reaction time, processing speed, memory, and functional performance than marginally dependent older adults. Functional performance is an independent predictor of level of independence. Leg power and cognition were separate small but significant predictors of independence. CONCLUSIONS: independent older adults have greater physiological, cognitive and functional performance than marginally dependent older adults. Individuals with greater functional performance tend to remain independent.

Activities of Daily Living↗

Daily ambulation activity and task performance in community-dwelling older adults aged 63-71 years with preclinical disability.

BACKGROUND: The purpose of this study was to examine differences in daily ambulation activity and task modification between community-dwelling older adults above and below an empirically derived physical threshold that has been linked to independence. METHODS: 20 community-dwelling older adults (72.8 +/- 6 years) were categorized into groups based on functional performance using the Continuous scale Physical Functional Performance Test total score (Cs-PFP). Individuals with Cs-PFP > or =57 were assigned to the high functioning group (HIGH; n=10) with all others assigned to the lower functioning group (LOW; Cs-PFP<57; n=10). Dependent variables included steps/day, number of tasks reported with difficulty, and number of tasks reported with modification. RESULTS: HIGH took significantly more steps/day (HIGH: 9503 +/- 4623; LOW: 5048 +/- 2917, p=.019) compared to LOW. Groups reported having difficulty with a similar number of tasks (HIGH: 0.4 +/- 1; LOW: 1.0 +/- 1, p=.092) but LOW reported modifying a significantly larger number of tasks (HIGH: 0.3 +/- 1; LOW 1.4 +/- 1, p=.049). CONCLUSIONS: Older adults with preclinical disability have reduced daily ambulatory activity compared to older adults with high function despite a similar independent living status. Individuals compensate for reduced physical reserves by modifying the method of performing a task. Identifying early declines in physical ability through task modification and daily ambulation will provide the opportunity for timely intervention to older adults desiring to remain independent within a community-dwelling environment.

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Effect of strength and power training on physical function in community-dwelling older adults.

BACKGROUND: The performance of daily tasks, such as stair climbing or lifting an object, requires both muscle strength and power. Age-associated reductions in strength and power can affect an older adult's ability to complete daily tasks such as stair climbing and lifting a child. METHODS: The purposes of this study were to determine whether power training was more efficacious than strength training for improving whole-body physical function in older adults and to examine the relationship between changes in anaerobic power and muscle strength and changes in physical function. Thirty-nine men and women (mean age +/- SD = 72.5 +/- 6.3 years) with below-average leg extensor power were randomly assigned to control (C, n = 15), strength-training (ST, n = 13) or power-training (PT, n = 11) groups. The ST and PT groups met 3 days per week for 16 weeks; the C group maintained usual activity and attended three lectures during the course of the study. Primary outcome measures included the Continuous Scale Physical Functional Performance test, maximal strength, and anaerobic power. RESULTS: After baseline was controlled for, the Continuous Scale Physical Functional Performance test total score was significantly greater for the PT group than for the ST (p =.033) and C (p =.016) groups. Maximal strength was significantly greater for the ST group than for the C group (p =.015) after the intervention. There was no significant difference between groups for peak anaerobic power. CONCLUSIONS: Power training was more effective than strength training for improving physical function in community-dwelling older adults.

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Resistance training on physical performance in disabled older female cardiac patients.

PURPOSE: We evaluated the value of resistance training on measures of physical performance in disabled older women with coronary heart disease (CHD). METHODS: The study intervention consisted of a 6-month program of resistance training in a randomized controlled trial format. Training intensity was at 80% of the single-repetition maximal lift. Control patients performed light yoga and breathing exercises. Study participants included 42 women with CHD, all >or= 65 yr of age and community dwelling. Subjects were screened by questionnaire to have low self-reported physical function. The primary study measurements related to the performance of 16 household activities of the Continuous Scale Physical Functional Performance test (CSPFP). These ranged from dressing, to kitchen and cleaning activities, to carrying groceries and walking onto a bus with luggage, and a 6-min walk. Activities were measured in time to complete a task, weight carried during a task, or distance walked. Other measures included body composition, measures of aerobic fitness and strength, and questionnaire-based measures of physical function and depression score. RESULTS: Study groups were similar at baseline by age, aerobic capacity, strength, body composition, and in performing the CSPFP. After conditioning, 13 of 16 measured activities were performed more rapidly, or with increased weight carried, compared with the control group (all P < 0.05). Maximal power for activities that involved weight-bearing over a distance, increased by 40% (P < 0.05). CONCLUSIONS: Disabled older women with CHD who participate in an intense resistance-training program improve physical capacity over a wide range of household physical activities. Benefits extend beyond strength-related activities, as endurance, balance, coordination, and flexibility all improved. Strength training should be considered an important component in the rehabilitation of older women with CHD.

Activities of Daily Living↗

Maximal voluntary and functional performance levels needed for independence in adults aged 65 to 97 years.

BACKGROUND AND PURPOSE: Age-related loss of muscle mass and cardiovascular endurance can lead to impairments in muscle force production and cardiac function that, in turn, limit performance in activities essential to everyday living. The purposes of this study were: (1) to identify the "breakpoint" or threshold of maximal voluntary performance and performance in ordinary daily function and (2) to evaluate the predictive validity of the threshold to identify the ability to live independently without self-reported functional limitation. SUBJECTS AND METHODS: Men and women (N=192; mean age=76 years, SD=7, range=65-97) were recruited from single-family community dwellings or retirement communities with multiple levels of care. Physical function was measured with the Continuous-Scale Physical Functional Performance Test (CS-PFP). Maximal voluntary performance measures included peak oxygen consumption (VO(2peak)) and isokinetic knee extensor torque (KET). Segmented linear regression models of the CS-PFP on the physical performance measures were used to determine the threshold values and their confidence intervals. A logistic regression model was used to evaluate the ability of the CS-PFP scores to identify those living independently and to further illustrate the concepts of threshold and physical reserve. RESULTS: Threshold values identified for VO(2peak) (20 mL x kg(-1) x min(-1)) and KET (2.5 N x m/[kg x m(-1)]) were associated with an average of CS-PFP score of 57 units. The threshold accurately predicted individuals reporting functional limitations. DISCUSSION AND CONCLUSION: The thresholds provide a mechanism for easily estimating an individual's physical reserve, predicting dependency in living status, and providing unbiased guidance for intervention in late-life independence.

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Anaerobic power and physical function in strength-trained and non-strength-trained older adults.

BACKGROUND: Challenging daily tasks, such as transferring heavy items or rising from the floor, may be dependent on the ability to generate short bursts of energy anaerobically. The purposes of this study were to determine if strength-trained (ST) older adults have higher anaerobic power output compared with non-strength-trained (NST) older adults and to determine the relationship between anaerobic power and performance-based physical function. METHODS: Thirty-five men and women (age 71.5 +/- 6.4 years, mean +/- SD; NST: n = 18, ST: n = 17) were grouped by training status. Outcome variables included relative anaerobic power (Wingate test), physical function measured with the Continuous Scale Physical Functional Performance Test (CS-PFP, scaled 0 to 100), and anthropometric lean thigh volume (LTV). Analysis of covariance (with age and sex as covariates) was used to determine group differences in the dependent variables listed above. Pearson's r was used to determine the relationship between anaerobic power, CS-PFP total score (TOT), and CS-PFP lower body strength domain score (LBS). RESULTS: The ST group had significantly higher mean anaerobic power (NST 58.9 +/- 16 W/l, ST 96.3 +/- 23 W/l), CS-PFP total (NST 61.2 +/- 13, ST 73.7 +/- 8), and LBS (NST 54.1 +/- 17, ST 70.9 +/- 8) compared with the NST group (p <.05). However, LTV was similar for both groups (NST 3.323 +/- 0.75; ST 3.179 +/- 0.79), which suggests that the ST group had higher muscle quality compared with the NST group. Anaerobic power was significantly related to TOT (r =.611, p =.001) and LBS (r =.650, p =.001). CONCLUSIONS: High levels of physical function in ST older adults may in part be explained by higher levels of anaerobic power associated with strength training.

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Effects of resistance training on physical function in older disabled women with coronary heart disease.

We studied whether disabled older women with coronary heart disease can perform resistance training at an intensity sufficient to improve measured and self-reported physical function [n = 30, 70.6 +/- 4.5 (SD) yr]. Compared with the controls, the resistance-training group showed significant improvements in overall measured physical function score using the Continuous-Scale Physical Functional Performance Test (+24 vs. +3%). The Continuous-Scale Physical Functional Performance Test measures physical function for 15 practical activities, such as carrying groceries or climbing stairs. Resistance training led to improved measures for domains of upper body strength (+18 vs. +6%), lower body strength (+23 vs. +6%), endurance (+26 vs. +1%), balance and coordination (+29 vs. -2%), and 6-min walk (+15 vs. +7%). Women involved in the flexibility-control group showed essentially no improvement for physical function measures. No changes were observed for body composition, aerobic capacity, or self-reported physical function in either group. In conclusion, disabled older women with coronary heart disease who participate in strength training are able to train at an intensity sufficient to result in improvements in multiple domains of measured physical functional performance, despite no change in lean body mass.

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Physical functional performance in persons using a manual wheelchair.

STUDY DESIGN: Descriptive study. OBJECTIVES: To develop a performance-based physical functional measure for people using a manual wheelchair, and to evaluate the feasibility and reliability of the administration of the new procedure. BACKGROUND: Most performance-based measures of physical function focus on balance and ambulation impairments. Recent developments of performance measures fail to produce a valid and reliable performance-based measure to quantify physical function in people who must rely on upper-body function to mobilize. METHODS: Eighteen adults (ages 18 to 67 years) who used a nonmotorized wheelchair participated in this study. Volunteers performed selected tasks from the Continuous Scale Physical Functional Performance (CS-PFP) test, modified for persons using a wheelchair. Outcome measures included scores on the Wheelchair Physical Functional Performance (WC-PFP) test and the Sickness Impact Profile (SIP) questionnaire. RESULTS: Participants had substantial disability (mean total SIP > 20). Total and domain scores of the WC-PFP had no ceiling or floor effects and were reproducible with intraclass correlation coefficients ranging from 0.87 to 0.96. Poorer self-rated health was correlated with poorer performance in the upper-body domain of the WC-PFP (r = -0.45). Those reporting disability in bathing and dressing using the SIP had significantly lower WC-PFP scores, indicating that the WC-PFP had construct validity. A significant correlation was not found between WC-PFP and the ambulation and mobility domains of the SIP. CONCLUSION: The WC-PFP provides a reliable and quantifiable measure of mobility in persons who use a manual wheelchair.

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