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Results for “Physical Functional Performance”

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At least 343 records · Page 19Linked to original sources

PubMed2002

Physical exercise or micronutrient supplementation for the wellbeing of the frail elderly? A randomised controlled trial.

OBJECTIVE: To examine the effects of 17 weeks of physical exercise and micronutrient supplementation on the psychological wellbeing of 139 independently living, frail, elderly subjects (inactive, body mass index < or =25 or experiencing weight loss). METHODS: Participants (mean (SD) age 78.5 (5.7)) were randomly assigned to: (a) comprehensive, moderate intensity, group exercise; (b) daily micronutrient enriched foods (25-100% recommended daily amount); (c) both; (d) neither. A social programme and identical regular foods were offered as attention control and placebo. RESULTS: At baseline, moderate to low but significant correlations were found between general wellbeing scores and physical fitness (r = 0.28), functional performance (r = 0.37), and blood concentrations of pyridoxine (r = 0.20), folate (r = 0.25), and vitamin D (r = 0.23) (all p values < or =0.02), but not with physical activity levels and other blood vitamin concentrations. General wellbeing score and self rated health were not responsive to 17 weeks of exercise or nutritional intervention. CONCLUSION: Psychological wellbeing in frail elderly people was not responsive to 17 weeks of intervention with exercise and/or micronutrient enriched foods. The moderate but significant correlations between wellbeing and physical fitness and several blood vitamin concentrations at baseline suggest that changes in wellbeing may occur after long term interventions.

Activities of Daily Living↗

PubMed2003

Changes in function and disability after resistance training: does velocity matter?: a pilot study.

OBJECTIVE: To compare the effects of high- and low-velocity resistance training on functional performance and disability outcomes in physically limited older women. DESIGN: A total of 16 wk of high-velocity resistance training or traditional low-velocity resistance training consisting of knee extension and leg press exercises was performed three times per week by 30 women with self-reported disability to compare their effect on functional performance and disability. Tests of dynamic balance, stair-climb time, chair-rise time, and gait velocity were used to assess changes in functional performance. Changes in disability were assessed using the Medical Outcomes Study Short Form. RESULTS: Dynamic balance and stair-climb time improved 8% and 10%, respectively, with training. Self-reported disability, physical functioning, role physical, and mental health improved 11, 9, and 5% with training, respectively. There were no significant differences between high- and low-velocity training groups. CONCLUSIONS: High- and low-velocity training achieved similar improvements in functional performance and disability. Improvements in functional performance and disability were modest compared with robust increases in strength and power. Specific modes of training or behavioral strategies may be necessary to optimize improvements in these outcomes.

Aged↗

PubMed2006

Effects of ACE inhibitors on skeletal muscle.

Angiotensin-converting enzyme (ACE) inhibitors reduce morbidity, mortality, hospital admissions, and decline in physical function and exercise capacity in congestive heart failure (CHF) patients. These therapeutic effects are attributed primarily to beneficial cardiovascular actions of these drugs. However, it has been suggested that ACE inhibitor-induced positive effects may also be mediated by direct action on the skeletal muscle. In particular, two recently published observational studies documented that among hypertensive subjects free of CHF, treatment with ACE inhibitors was associated with better performance and muscular outcomes and genetic studies also support the hypothesis that the ACE system may be involved in physical performance and skeletal muscle function. Effects on the skeletal muscle are probably mediated by mechanical, metabolic, anti-inflammatory, nutritional, neurological and angiogenetic actions of these drugs. These studies may have major public health implications for older adults, as consequence of the fact that, in this population, gradual loss of muscle mass and muscle strength can play a key role in the onset and progression of disability. Therefore, if findings of observational studies will be later confirmed in randomized controlled trials, ACE inhibitors could represent an effective intervention to prevent physical decline in the elderly, leading to greater autonomy in this growing population.

Aged↗

PubMed1997

Clinical predictors of declines in physical functioning in persons with AIDS: results of a longitudinal study.

OBJECTIVE: This study was performed in an attempt to determine clinical correlates of declines in physical functioning in people with AIDS. DESIGN: An 8-month longitudinal cohort study was performed at three sites in Boston, Massachusetts: a private academic group practice, an AIDS clinic at a public teaching hospital, and a staff-model health maintenance organization. Intermediate activities of daily living (IADLs), 10 symptoms and symptom complexes, mental health, and weight loss were assessed by interview in 201 persons with AIDS. Clinical diagnoses, comorbidities, laboratory results, and use of selected medications were assessed by chart review. RESULTS: Participants were young (mean age, 36 years), 92% were male, 35% were nonwhite, and 27% had a history of injection drug use. The mean 8-month decrement in physical functioning was 9.6 points on a 100-point scale, and mean weight loss was 2.3 kg. After adjusting for baseline functioning, age, sex, race, and educational level, independent predictors of the 8-month IADL score included worsening fatigue (p = .0002), worsening neurologic symptoms (p = .001), weight loss (p = .0001), Candida esophagitis (p = .020), hypertension (p = .0005), depression (p = .004), and gastrointestinal (GI) disease (p = .018, model R2 = 0.56). CONCLUSIONS: Two symptom complexes (fatigue and neurologic symptoms), three comorbidities (hypertension, depression, and GI disease), and weight loss were significant independent predictors of 8-month IADL scores after statistically controlling for baseline IADL score and sociodemographic variables. These clinical factors are potential targets for interventions designed to improve physical functioning.

Acquired Immunodeficiency Syndrome↗

PubMed1998

Self-reported and performance-based functional status and associated factors among elderly men: the Finnish cohorts of the Seven Countries Study.

Health and functional status were studied in 470 men aged 70-89, the survivors of the Finnish cohorts of the Seven Countries Study. We aimed to compare subjective (self-reported activity of daily living [ADL]) and objective methods (four physical performance tests) in the assessment of physical function and to identify which factors are related to physical function. Poor ADL and decreased physical performance were mainly explained by the same health-related factors. The strongest determinants of ADL were depressive symptomatology odds ratio [OR] 4.8, 95% confidence interval [CI] 2.7-8.8), osteoarthritis (OR 3.3, 95% CI 1.8-5.9), vertigo (OR 2.5, 95% CI 1.2-5.5) and diabetes (OR 2.3, 95% CI 1.2-4.6). Self-reported ADL and performance-based measures were in general strongly correlated with each other, although there was some discordance owing to the fact that these performance tests examine functional limitations, whereas the self-reported ADL reflects disability. The choice of which measurement to use in assessing functional status should be based on research objectives and the type of population under study.

Activities of Daily Living↗

PubMed2000

[Determinations and analysis of masticatory performance in unilateral cleft lip and palate].

OBJECTIVE: Masticatory function is one of the most important physical functions in craniomaxilla system. Masticatory performance is evaluated with the degree of broken dawn tested food in a limited period of time. Unilateral cleft lip and palate (UCLP) is a congenital abnormality in craniofacial growth and developing. It seriously damages face esthetics and masticatory function in UCLP patients. METHODS: 28 UCLP patients (male 17, female 11, permanent teeth) were selected, which all had received plastic operation treatments and never received any orthodontic therapy. The masticatory performance was determined by the advanced light absorbtion method and took peanuts as tested food. Meanwhile, malocclusal patterns and castings were identified in clinic. All of the data were treated with t-test and step wise-regression in statistics. RESULTS: 1. Masticatory performance of male was higher than that of female in normal people, but there was no sexual difference in UCLP. 2. Masticatory performance in UCLP was lower about 53.97% than that in normal people. 3. Different masticatory times within limited time had no effects on masticatory performance. 4. Different Patterns of malocclusion had different effects on masticatory performance. CONCLUSION: Orthodontic therapy is necessary to improve masticatory function in UCLP after plastic surgery.

Adolescent↗

PubMed2001

Physical exercise and/or enriched foods for functional improvement in frail, independently living elderly: a randomized controlled trial.

OBJECTIVE: To examine the effects of an exercise program and an enriched food regimen on physical functioning of frail elderly persons. DESIGN: A 17-week randomized, placebo-controlled trial. SETTING: Community. PARTICIPANTS: One hundred fifty-seven independently living frail elderly (mean age, 78.7 +/- 5.6yr). INTERVENTION: Thirty-nine subjects participated in a twice weekly group exercise designed to improve daily functioning; 39 subjects daily ate foods enriched with vitamins and minerals (at 25%-100% of the recommended daily allowances); 42 subjects exercised and ate enriched foods; and 37 subjects served as controls. Nonexercising groups followed a social program; nonsupplement groups received the same food products without the micronutrients. MAIN OUTCOME MEASURES: Functional performance based on 6 performance tests, physical fitness based on 7 fitness tests, and disabilities based on the self-reported ability to perform 16 daily activities. RESULTS: Performance sum scores were significantly enhanced in trained (+8%) compared with nontrained subjects (-8%) (difference in change: 1.9 points, p < .001, adjusted for baseline scores). Fitness sum scores were significantly enhanced as well (+3% in trained vs -2% in nontrained) (difference in change: 0.9 points, p = .05, adjusted for baseline scores). No exercise effects on the disability score were observed. Consumption of enriched products did not affect performance, fitness, or disability scores. CONCLUSION: Our comprehensive exercise program, designed for widespread applicability, enhanced physical performance and fitness in a population of frail elderly. Daily consumption of micronutrient enriched foods showed no functional benefits within 17 weeks.

Activities of Daily Living↗

PubMed2002

Short-term change in physical function and disability: the Women's Health and Aging Study.

OBJECTIVES: Although measures of physical function are predictive of future disability, little is known about the short-term impact of changes in physical function on disability. METHODS: Data from 93 of the 102 women who participated in the Weekly Substudy of the Women's Health and Aging Study (WHAS) were used to explore the association of changes in physical function with disability. The WHAS Substudy included 24 weekly assessments of three standard performance tests and self-reported disability in activities of daily living (ADLs) and basic mobility. RESULTS: Using random-effects models, we found small but significant (ps <.01) changes in ADL and mobility disability during weekly follow-up. Baseline performance scores were significantly associated with both ADL and mobility disability (ps <.001), accounting for 27% and 36% of the between-person variability in each type of disability, respectively. After adjustment for baseline scores, change in performance scores was significantly associated with ADL disability (beta = 0.08, p <.01) and mobility disability (beta = 0.12, p <.001), but accounted only for a small proportion (<10%) of the variability in the rate of change in disability outcomes. There was no evidence for an additional effect on either type of disability because of having a single episode of a higher or lower than usual performance score, or because of periods of at least 4 consecutive higher or lower than usual performance test scores. DISCUSSION: Basic physical functions account for a substantial proportion of the heterogeneity in ADL and mobility disability among older disabled women, but have a relatively small impact on short-term changes in either type of disability. Effective prevention of disability may require attention to a wider array of risk factors than just limitations in basic physical functions.

Aged↗

PubMed2003

A home-based pedometer-driven walking program to increase physical activity in older adults with osteoarthritis of the knee: a preliminary study.

OBJECTIVES: To determine whether a home-based pedometer-driven walking program with arthritis self-management education (Walk +) would increase physical activity, muscle strength, and functional performance in older adults with osteoarthritis (OA) of the knee as opposed to arthritis self-management education alone (EDU). DESIGN: A randomized two-by-three (group-by-time) design with participants assigned to Walk + (n = 17, mean age +/- standard deviation = 69.6 +/- 6.7) or EDU (n = 17, age = 70.8 +/- 4.7). SETTING: Community located in the Baltimore-Washington area. PARTICIPANTS: Thirty-four community-dwelling adults, aged 60 and older with symptomatic knee OA and self-reported functional impairment. INTERVENTIONS: Both groups received 12 hours of the Arthritis Self-Management program over 12 weeks and were followed for an additional 12 weeks. In addition, the Walk + group received individualized instruction in the use of a pedometer, with the goal of increasing their step count by 30% of their baseline step count. MEASUREMENTS: The outcome measures were physical activity (daily step counts and total activity vector magnitude as measured by a pedometer and Tritrac-R3D accelerometer), quadriceps femoris strength (isometric peak torque), and functional performance tasks (100-foot walk-turn-walk, timed stair climb, timed chair rise, and pain status). RESULTS: Daily steps walked showed a significant group-by-time interaction (P =.04) after controlling for age. From baseline to completion of training, a 23% increase in daily steps occurred in the Walk + group and a 15% decrease in the EDU group. Although steps increased in the Walk + group, total activity vector magnitude was maintained, suggesting a more efficient gait. The Walk + group became quicker than the EDU group in the normal-pace walk-turn-walk (P =.04). An isometric strength gain of 21% postintervention was seen in the Walk + group, compared with a loss of 3.5% in the EDU group. CONCLUSION: In older adults with symptomatic knee OA, Walk + appears to increase walking, with improvements in muscle strength and walking performance. The use of a home-based pedometer-driven program to increase physical activity, strength, and function in this population warrants further research.

Aged↗

PubMed2004

Constraints on muscular performance: trade-offs between power output and fatigue resistance.

An important functional and evolutionary constraint on the physical performance of vertebrates is believed to be the trade-off between speed and endurance capacity. However, despite the pervasiveness of physiological arguments, most studies have found no evidence of the trade-off when tested at the whole-animal level. We investigated the existence of this trade-off at the whole-muscle level, the presumed site of this physiological conflict, by examining inter-individual variation in both maximum power output and fatigue resistance for mouse extensor digitorum longus (EDL) muscle using the work-loop technique. We found negative correlations between several measures of in vitro maximum power output and force production with fatigue resistance for individual mouse EDL muscles, indicating functional trade-offs between these performance parameters. We suggest that this trade-off detected at the whole-muscle level has imposed an important constraint on the evolution of vertebrate physical performance.

Animals↗

PubMed1998

Pulmonary and cardiac function in advanced fibrodysplasia ossificans progressiva.

Fibrodysplasia ossificans progressiva is a rare genetic disease characterized by heterotopic ossification in soft tissues. Severe disability results from progressive immobilization of the limbs, jaw, and chest wall. To determine whether cardiac function is altered in this disease, 25 patients ranging in age from 5 to 55 years (disease duration 1-51 years) were studied. History, physical examination, pulmonary functions, electrocardiography, and echocardiography were performed on each patient. Physical examination of the lungs and heart was unrevealing; no right sided ventricular gallops were heard, and no patient was found to have neck vein distention or peripheral edema. The patients had extremely limited chest expansion (1.9 +/- 0.8 inches), suggesting dependence on diaphragmatic breathing. Lung volumes were severely reduced (mean forced vital capacity 44% +/- 14% of predicted), but flow rates were relatively normal. All patients had normal capillary oxygen saturation. Echocardiography was technically difficult, but no abnormalities of left or right ventricular function were seen. Ten (40%) patients had electrocardiographic evidence of right ventricular dysfunction. Compared with patients without such evidence, these patients were older, had significantly longer disease duration, higher hemoglobin, and more impaired pulmonary function. The results of this study suggest that the presence of severely restrictive chest wall disease is associated with a high incidence of right ventricular abnormalities on electrocardiogram. Whether cor pulmonale will eventually occur remains to be determined.

Adolescent↗

PubMed2005

Performance measures were necessary to obtain a complete picture of osteoarthritic patients.

OBJECTIVES: Self-report questionnaires and performance measures represent two methods for assessing physical function. A recurring theme is that self-report measures are superior to performance measures. This study investigated the association between three performance test outcomes of four activities (pain, exertion, and time or distance; for self-paced walk, stair test, timed up-and-go, 6-minute walk) with self-reports of physical function (WOMAC Physical Function subscale and LEFS) and the association between the change scores of the performance tests and those of the self-report measures. STUDY DESIGN AND SETTING: Performance and self-report measures were administered three times (presurgery and at approximately 1 week and approximately 8 weeks post arthroplasty) to 85 patients who underwent total hip or knee arthroplasty. Components of the performance tests were pooled within each domain across the four measures. Multiple regression analyses were applied. Independent variables were performance tests components; dependent variables were self-report measures. Standardized regression coefficients described the cross-sectional and longitudinal associations. RESULTS: Pain was the principal determinant of WOMAC Physical Function subscale scores. Pain, exertion, and time or distance were strongly associated with the LEFS at the first, second, and third assessments, respectively. Change in pain was most strongly associated with change in self-reported physical function. CONCLUSION: Our findings caution against the isolated use of self-report assessments of physical function.

Aged↗

PubMed1991

Cognitive impairment and functional disability in the absence of psychiatric diagnosis.

Data from the 1981 East Baltimore Mental Health Survey were used to examine the relationship between cognitive impairment and psychiatric diagnosis in an adult population. The Mini-Mental State Examination was administered to 3841 household respondents and a subset of 810 received psychiatric evaluations. Of the 810, 23% were found to be cognitively impaired. Over one-third of those with cognitive impairment, however, did not meet DSM-III criteria for a psychiatric diagnosis. Education, geographical background, race and neurological status were predictive of cognitive performance. There was no linear effect of age on cognitive performance with disease status and education controlled. In addition to their cognitive impairment these individuals, who ranged in age from 19 to 89, were found to have significant functional disabilities. Cognitive performance itself, along with physical and emotional health, predicted total functional disability.

Activities of Daily Living↗

PubMed2002

Intraindividual variability in cognitive performance in three groups of older adults: cross-domain links to physical status and self-perceived affect and beliefs.

Intraindividual variability of physical status and affect/beliefs as well as their relations with cognition were examined in 3 groups of older adults: healthy elderly, individuals with a nonneurological health-related disturbance (arthritis) and people with neurological compromise (dementia). The findings showed that greater inconsistency in physical performance was observed in groups characterized by central nervous system dysfunction. By contrast, fluctuations in affect appeared to reflect other more transient sources, such as pain. In general, increased inconsistency in non-cognitive domains was associated with poorer cognitive function. There were cross-domain links between inconsistency in physical functioning and fluctuations in cognitive performance, although the nature of the links depended largely upon the neurological status of the individuals. Considered together, the result indicated that measures of cognitive as well as physical variability are important behavioral markers of neurological integrity.

Affect↗

PubMed1976

A test of the practical value of estimating breath sound intensity. Breath sounds related to measured ventilatory function.

Each of four examiners performed standardized physical examinations on a group of patients who had just undergone tests of ventilatory function. The intensity of breath sounds heard with deep inspiration was graded on a rating scale of 0 to 4; the grades in six areas of the chest were added to give a total score, with possible values ranging from 0 to 24. Correlation of breath-sound scores with percentage of predicted forced expiratory volume in one second (FEV1) was significant at the 1 percent level for all of the examiners. Differences between the examiners in their assessment of breath sounds were not statistically significant. Grading the loudness of breath sounds was a poor screening test for mild ventilatory abnormality, but normal breath sounds nearly excluded the possibility of severe reduction in the FEV1. Definitely reduced breath-sound intensity was strong evidence for the presence of obstructive pulmonary disease.

Adult↗

PubMedDate not supplied

Welfare reform: loss of supplemental security income (SSI) for children with disabilities.

PURPOSE: To describe the changes the new welfare reform legislation, the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, makes in children's eligibility for Supplemental Security Income (SSI) and the implications of the changes for low-income children with disabilities and their families. POPULATION: Low-income children and youth, 18 years of age and younger, who have one or more limitations in physical or mental function in performing age-appropriate skills. CONCLUSIONS: The tightened federal standards for determining whether children are disabled place thousands of children at risk for losing SSI cash benefits. This loss of necessary financial support has the potential to adversely affect the physical and psychological health of low-income children with disabilities and their families. The new law represents a step backward from the long awaited gains the 1990 Zebley v. Sullivan U. S. Supreme Court decision legislated for children with disabilities. PRACTICE IMPLICATIONS: Knowledge of the legal changes in children's SSI enables nurses to implement interventions that help low-income families maintain SSI eligibility for their children with disabilities and to advocate with the public and policymakers on behalf of this vulnerable population.

Child↗

PubMed2003

The effect of order of testing in functional performance in persons with and without chronic back pain.

Batteries of individually standardized physical and functional tests are commonly used to assess persons with chronic back pain disability. The order of testing may affect performance on later tests. One hundred and fifty patients with > 3 months of back pain disability underwent a multidisciplinary Spine Team Assessment involving Physical Therapy, Occupational Therapy, Pain Psychology, and Vocational Rehabilitation Counselor assessments at a university spine clinic. Seventeen back healthy volunteers performed the physical component of the assessment. For the volunteers the order of testing was randomized to OT tests first or PT test first, with 0.5 h rest between the tests. For patients the order of testing was arbitrarily set by an alternating schedule, with 1 h psychological testing between the two components. For both the patients and volunteers, among the 14 test components, there was no significant difference (p > 0.05) in performance with order of testing. This held true for the subgroup of patients who put out good cardiac effort. Volunteers performed better than patients on all individual tests (p < 0.001). Results suggest that the order of physical testing during a Spine Team Assessment does not affect test performance either in chronic low back disabled patients or in volunteers.

Adult↗

PubMedDate not supplied

The mediating effect of pain and fatigue on level of functioning in older adults.

BACKGROUND: Medical conditions and symptoms have been shown to predict level of functioning in older adults, but medical conditions and symptoms have rarely been investigated together in a comprehensive model that included both medical conditions and symptoms as predictors of functioning in older adults. OBJECTIVE: The purpose of this study was to determine whether the adverse effect of medical conditions on different aspects of functioning in older adults is mediated by the level of symptoms (pain and fatigue). If so, level of functioning may improve if pain or fatigue can be mitigated, even when underlying medical conditions cannot be cured. METHOD: Data from 225 adults aged 65-90 were used to test whether medical conditions, symptoms (pain and fatigue), and six covariates predicted lower body performance, self-reported physical functioning, and self-reported role and social functioning. The fit of a series of models to the data was analyzed using structural equation modeling. RESULTS: Medical conditions affected self-reported physical functioning and self-reported role and social functioning by increasing the level of symptoms, rather than by direct association. Further descriptive studies are needed to identify other symptoms and modifiable mechanisms by which medical conditions affect functioning. Researchers who investigate the causes of poor functioning in older adults are encouraged to include symptoms in models that hypothesize medical conditions as predictors of functioning outcomes.

Activities of Daily Living↗