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PubMedDate not supplied

Significance of behavioral pathology on functional performance in individuals with Alzheimer's disease and related dementias.

Insight on the role of frontal systems functioning has led to the development of measures targeting behaviors mediated through the prefrontal cortex. The current review investigated the relationship of behavioral pathology to functional performance in individuals with dementia and discussed the association of behavioral pathology and executive dysfunction. Results indicated that both behavioral measures and cognitive status were strongly correlated to functional performance. However, neither behavioral measure nor cognitive status demonstrated a stronger association to functional performance at a greater consistency than the other measure. This review has important implications for the use of behavior measures by medical practitioners to determine the functional status of persons with Alzheimer's disease (AD) and other dementias and the use of results obtained by these measures to develop appropriate intervention strategies.

Activities of Daily Living↗

PubMed1998

Isokinetic knee extensor strength and functional performance in healthy female soccer players.

The aims of this study were to determine the relationship between isokinetic knee extensor muscle strength at 60 degrees/s and 180 degrees/s and five functional performance tests (one-leg-hop, triple-jump, vertical-jump, one-leg-rising and square-hop), to determine the relationship between the five different functional performance tests and to present normative data and limb symmetry index concerning healthy female soccer players. In total 101 female soccer players (X = 20.3 years) were tested. A limb symmetry index, using weak/strong leg, varied from 83.9 to 96.3 in the tests. Between the functional performance tests there were in general correlations of r = 0.4-0.8 (P < 0.001). A correlation of r = 0.77 (P < 0.001) was obtained between one-leg-hop and triple-jump. No differences were found between the right and the left leg or the dominant and the non-dominant leg. Using linear regression models corrected for body weight, height and age, there were low correlations between the isokinetic strength measurements and the functional tests. It is not recommended using functional performance testing and isokinetic testing interchangeably.

Adult↗

PubMed2006

[Personal control of care provision and functional performance of non-institutionalized and institutionalized elderly].

The present study is part of a broader investigation on the effects of living in a home for the elderly on functional performance and opportunities for successful aging. Functional performance is defined as the daily activities people actually execute in the domains of housekeeping, self-care, and leisure and social activity. In this first study, a comparison was made between community dwelling elderly and aged people living in an institution, in order to investigate the effect of living in an institution on functional performance (FP) in different domains and on personal control (PC) of the received care. The data were gathered in a structured interview, administered to 74 non-institutionalized and 79 institutionalized elderly, aged 71 to 97 years, living in Flanders. We found institutionalized elderly to be less active in every domain of functioning and experiencing less control of the received care. Significant negative correlations between age, FP and PC were only found in the sample of community-dwellers. It seems that in homes for the elderly, care is provided in a package about which the residents have minimal control, which leads to a homogenisation of daily functioning in the institution.

Activities of Daily Living↗

PubMed1987

Validating a test of functional performance with psychiatric patients.

The primary purpose of the study was to contribute to the validation of a recently developed test of functional abilities, the Bay area Functional Performance Evaluation (BaFPE). On the premise that aspects of intelligence influence functional performance, three subscales of the Wechsler Adult Intelligence Scale (WAIS) were administered, in conjunction with the BaFPE task-oriented assessment (TOA), to a sample of 60 psychiatric inpatients with diagnosed depression or schizophrenia. The three subscales (picture completion, block design, and digit symbol) correlated significantly with the TOA, thus supporting its validity. A second goal was to determine what variables were predictors of functional performance. Age and history of electroconvulsive treatments were negatively associated with the TOA, and level of education was positively associated with it. Variables not associated with the TOA were diagnosis, gender, amount of medication, type of medication, number of admissions, and total time spent in a hospital in the past 2 years. Research and clinical implications are discussed.

Adult↗

PubMed2004

Lower levels of serum albumin and total cholesterol and future decline in functional performance in older persons: the Longitudinal Aging Study Amsterdam.

BACKGROUND: Both serum albumin and total cholesterol are potential markers of frailty. A decline in functional status is one of the key components of frailty. OBJECTIVE: The aim of this study was to investigate the association of serum albumin and total cholesterol, separately and combined, with future decline in functional performance. DESIGN: The Longitudinal Aging Study Amsterdam, an ongoing population-based longitudinal study, started in 1992/1993 with a follow-up every 3 years. PARTICIPANTS: 1,064 men and women aged 55-85 years with complete data on serum albumin and total cholesterol at baseline, and functional performance at baseline and 3-year follow-up. MEASUREMENTS: At baseline, serum albumin and total cholesterol were measured. At baseline and 3 years later, decline in functional status was measured with three performance tests (chair stand, 3-metre walk, putting on and taking off a cardigan). Associations were adjusted for age, life-style and health-related factors. RESULTS: Albumin concentration was not associated with decline in functional performance in men and women. Women with lower serum total cholesterol concentration (</=5.2 mmol/l) were more likely to decline in functional status compared to women with higher serum total cholesterol concentration (reference; OR = 2.50; 95% CI 1.07-5.84). Men with lower serum albumin (</=43 g/l) and lower serum total cholesterol concentration were three times more likely to decline in functional performance compared to men with higher levels (OR = 3.00; 95% CI 1.00-8.97). In women, a similar trend was found (OR = 1.73; 95% CI 0.34-8.94), although not statistically significant. CONCLUSIONS: A combination of low albumin and low cholesterol levels may increase the risk of future functional decline.

Activities of Daily Living↗

PubMed1997

Effect of ankle orthoses on functional performance for individuals with recurrent lateral ankle sprains.

Ankle orthoses are commonly used for protection against initial ankle sprain injuries and for protection against reinjury. The purpose of this study was to compare the effects of the DonJoy Ankle Ligament Protector (ALP) and the Aircast Sport-Stirrup (AS) on the functional performance tasks of a 40-meter sprint, a figure-of-eight run, and standing vertical jump. Subjects were 14 males and nine females who reported a history of two or more lateral ankle sprains of the same ankle and no sprains of the contralateral ankle. Each subject performed all functional tasks on the first test day with both ankles unbraced and with the recurrently sprained ankle braced with one of the two orthoses. Each subject returned for testing on a second day and performed all tasks with both ankles unbraced and with the other orthosis on the recurrently sprained ankle. Subjects also rated the orthoses for comfort and support. Analysis of variance indicated that braced data were not significantly different than unbraced data and that data for the two orthoses did not differ significantly for any of the functional performance tasks. Seventy-four percent of the subjects reported the AS was more comfortable than the ALP, and 61% of the subjects indicated that the AS provided more support than the ALP. Neither orthosis had an effect on functional performance. The results may assist clinicians in selecting either of these orthoses for use in protection against ankle sprain injury.

Adolescent↗

PubMed2002

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.

Activities of Daily Living↗

PubMed2004

Reduced functional performance in the lower extremity predicted radiographic knee osteoarthritis five years later.

BACKGROUND: Reduced quadriceps strength is an early finding in subjects with knee osteoarthritis, but it is not clear whether it is a cause or a consequence of knee osteoarthritis. OBJECTIVE: To determine whether reduced functional performance in the lower extremity predicts the incidence or progression of radiographic knee osteoarthritis. DESIGN: Prospective, epidemiological, population based cohort study. PATIENTS: 148 subjects (62 women), aged 35-54 (mean 44.8), with chronic knee pain from a population based cohort. MEASUREMENTS: Predictors analysed were age, sex, body mass index, baseline knee pain, and three tests of lower extremity functional performance: maximum number of one-leg rises from sitting, time spent walking 300 m, and timed standing on one leg. Weightbearing tibiofemoral knee radiographs were obtained at baseline and after 5 years (median 5.1, range 4.2-6.1), and classified according to Kellgren and Lawrence as no osteoarthritis (Kellgren and Lawrence = 0, n = 94) or prevalent osteoarthritis (Kellgren and Lawrence >/=1, n = 54). RESULTS: Fewer one-leg rises (median 17 v 25) predicted incident radiographic osteoarthritis five years later (OR 2.6, 95% CI 1.1 to 6.0). The association remained significant after controlling for age, sex, body mass index, and pain. No significant predictor of radiographic progression in the group with prevalent osteoarthritis was found. CONCLUSION: Reduced functional performance in the lower extremity predicted development of radiographic knee osteoarthritis 5 years later among people aged 35-55 with chronic knee pain and normal radiographs at baseline. These findings suggest that a test of one-leg rises may be useful, and interventions aimed at improving functional performance may be protective against development of knee osteoarthritis.

Adult↗

PubMed1998

Quadriceps function, proprioceptive acuity and functional performance in healthy young, middle-aged and elderly subjects.

BACKGROUND: Muscle functions to generate force-producing movement and also has a role in proprioception. If ageing compromises these sensorimotor functions of muscle, the ability of older subjects to detect and correct postural sway may be impeded, resulting in impairment of functional performance. METHOD: To see if age-related changes occurred and, if so, what their effects might be. Quadriceps strength, proprioception, postural stability and functional performance were assessed in young (n = 20, mean age 23 years), middle-aged (n = 10, mean age 56 years) and elderly (n = 15, mean age 72 years) subjects. RESULTS: With increasing age there were decreases in quadriceps strength (r = -0.511; P < 0.001), acuity of joint position sense (r = -0.603; P < 0.001) and postural stability (ANOVA < 0.002) during stance conditions which placed a greater reliance on muscle proprioceptors. These changes may decrease postural stability confidence, resulting in impaired performance of common activities of daily living (r = 0.635; P < 0.001). CONCLUSIONS: The age-related deterioration in sensorimotor function of muscle may contribute to the increased fear and frequency of falls in elderly subjects, thereby decreasing independence.

Accidental Falls↗

PubMed2006

Effect of high versus low-velocity resistance training on muscular fitness and functional performance in older men.

This study investigated the effect of a 10-week power training (PT) program versus traditional resistance training (TRT) on functional performance, and muscular power and strength in older men. Twenty inactive volunteers (60-76 years old) were randomly assigned to a PT group (three 8-10 repetition sets performed as fast a possible at 60% of 1-RM) or a TRT group (three 8-10 repetition sets with 2-3 s contractions at 60% of 1-RM). Both groups exercised 2 days/week with the same work output. Outcomes were measured with the Rikli and Jones functional fitness test and a bench and leg press test of maximal power and strength (1-RM). Significant differences between and within groups were analyzed using a two-way analysis of variance (ANOVA). At 10 weeks there was a significantly (P < 0.05) greater improvement in measures of functional performance in the PT group. Arm curling improved by 50 versus 3% and a 30 s chair-stand improved by 43 versus 6% in the PT and TRT groups, respectively. There was also a significantly greater improvement in muscular power (P < 0.05) in the PT group. The bench press improved by 37 versus 13%, and the leg press by 31 and 8% in the PT and TRT groups, respectively. There was no significant difference between groups in improved muscular strength. It appears that in older men there may be a significantly greater improvement in functional performance and muscular power with PT versus low velocity resistance training.

Aged↗

PubMedDate not supplied

Usefulness of the human activity profile, a functional performance measure, in people with chronic obstructive pulmonary disease.

PURPOSE: To further evaluate the usefulness of the Human Activity Profile (HAP) as a functional performance measure for those with chronic obstructive pulmonary disease (COPD). METHODS: Phase 1. The sample consisted of 53 outpatients (51 male) with stable COPD (forced expiratory volume in 1 second% predicted (FEV1% pred) = 38 +/- 14 (mean +/- standard deviation) at a university-affiliated veterans affairs medical center. Variables were functional performance (HAP Maximal Activity Score [MAS], HAP Adjusted Activity Score [AAS]), dyspnea (modified Borg category-ratio scale and Shortness of Breath Questionnaire [SOBQ]), and exercise capacity (6-minute walk distance [6MWD]). Phase 2. The HAP was administered pre-post pulmonary rehabilitation in 48 (14 male) outpatients with stable COPD (FEV1% pred = 35 +/- 15) at an outpatient pulmonary rehabilitation program at a large private hospital. RESULTS: Phase 1. Scores for MAS and AAS were, respectively, 62 +/- 12 and 44 +/- 15. The 6MWD, modified Borg, and SOBQ were, respectively, 1055 +/- 372 ft, 4.1 +/- 1, and 64.4 +/- 22 ft. Correlations of the 6MWD and dyspnea scores with the AAS were strong and explained 40% of the AAS variation. Phase 2. The baseline MAS and AAS scores were 55 +/- 14 and 42 +/- 15, respectively, with 29/48 (60%) classified as "low fitness" on the basis of the AAS. Post-rehabilitation, there was significant improvement in the AAS score (48 +/- 13) and significant reduction for those classified as "low fitness." CONCLUSIONS: The utility of the HAP as a measure of functional performance improvement in COPD is supported by its relationship with both 6MWD and dyspnea and its responsiveness to pulmonary rehabilitation.

Aged↗

PubMed2005

Functional performance and quality of life related to training and detraining of community-dwelling elderly.

PURPOSE: Despite clear evidence of physiological declines during detraining, the effects of detraining on functional performance and quality of life have not often been investigated. The purpose of this study was to investigate functional performance and quality of life measures after a training and detraining programme with community-dwelling elderly. METHOD: Twenty-three subjects took part in a combined programme of muscle strengthening and aerobic conditioning twice a week and were assessed at baseline, after training, and after one, two, and three months of detraining. Functional performance was assessed by gait speed and by the rate of ascending and descending stairs, while quality of life was evaluated by the Nottingham Health Profile. RESULTS: Repeated measures ANOVA showed that gains observed in measures of gait speed, ascending, and descending stairs returned to baseline after one, two, and three months of detraining, respectively. However, the gains in quality of life remained unchanged. CONCLUSIONS: One-month detraining was enough to show functional decline, with gait speed the most sensitive parameter to detect these changes and QL measure most resilient, beneficial factor during the detraining process. Based on these findings, it is recommended that programmes devised for elderly should not be interrupted, to maintain the acquired benefits.

Activities of Daily Living↗

PubMed2001

Effects of knee bracing on the functional performance of patients with anterior cruciate ligament reconstruction.

OBJECTIVE: To compare the functional performance of subjects with unilateral anterior cruciate ligament (ACL) reconstruction. DESIGN: Cross-sectional comparative clinical trial. SETTING: A physical therapy outpatient department. SUBJECTS: Thirty-one subjects with unilateral ACL reconstruction for more than 5 months. INTERVENTION: Patients under 3 bracing conditions: (1) DonJoy Brace, (2) mechanical placebo brace, or (3) no brace. Running and turning 10 times on a 22-meter figure-8 runway, and running and jumping (and landing) on a semicircular path. MAIN OUTCOME MEASURES: Speed of running and turning, speed of running and jumping, and accuracy of landing after the jump. RESULTS: Subjects performed similarly in conditions 1 and 2 in all the tests, but the speeds of running and turning were significantly slower in conditions 1 and 2 than condition 3 (p =.008--.000). Results of the run and jump tests were not different among all conditions. CONCLUSION: Knee bracing may not improve functional performance of subjects 5 months after ACL reconstruction. The use of such a brace could actually slow down running and turning, irrespective of the mechanical constraints of the brace. These functional outcomes need to be noted when such a brace is used on this group of subjects.

Adult↗

PubMed2006

Effects of two 4-week proprioceptive neuromuscular facilitation programs on muscle endurance, flexibility, and functional performance in women with chronic low back pain.

BACKGROUND AND PURPOSE: Improving functional performance in patients with chronic low back pain is of primary importance. The purpose of this study was to examine the effects of 2 proprioceptive neuromuscular facilitation (PNF) programs on trunk muscle endurance, flexibility, and functional performance in subjects with chronic low back pain (CLBP). SUBJECTS: Eighty-six women (40.2+/-11.9 [mean+/-SD] years of age) who had complaints of CLBP were randomly assigned to 3 groups: rhythmic stabilization training, combination of isotonic exercises, and control. METHODS: Subjects trained with each program for 4 weeks with the aim of improving trunk stability and strength. Static and dynamic trunk muscle endurance and lumbar mobility were measured before, at the end of, and 4 and 8 weeks after training. Disability and back pain intensity also were measured with the Oswestry Index. RESULTS: Multivariate analysis of variance indicated that both training groups demonstrated significant improvements in lumbar mobility (8.6%-24.1%), static and dynamic muscle endurance (23.6%-81%), and Oswestry Index (29.3%-31.8%) measurements. DISCUSSION AND CONCLUSION: Static and dynamic PNF programs may be appropriate for improving short-term trunk muscle endurance and trunk mobility in people with CLBP.

Adult↗

PubMed2002

Intrarater Reliability of Functional Performance Tests for Subjects With Patellofemoral Pain Syndrome.

OBJECTIVE: Patellofemoral pain syndrome (PFPS) is a common clinical entity seen by the sports medicine specialist. The ultimate goal of rehabilitation is to return the patient to the highest functional level in the most efficient manner. Therefore, it is necessary to assess the progress of patients with PFPS using reliable functional performance tests. Our purpose was to evaluate the intrarater reliability of 5 functional performance tests in patients with PFPS. DESIGN AND SETTING: We used a test-retest reliability design in a clinic setting. SUBJECTS: Two groups of subjects were studied: those with PFPS (n = 29) and those with no known knee condition (n = 11). The PFPS group included 19 women and 10 men with a mean age of 27.6 +/- 5.3 years, height of 169.80 +/- 10.5 cm, and weight of 69.59 +/- 15.8 kg. The normal group included 7 women and 4 men with a mean age of 30.3 +/- 5.2 years, height of 169.55 +/- 9.9 cm, and weight 69.42 +/- 14.6 kg. MEASUREMENTS: The reliability of 5 functional performance tests (anteromedial lunge, step-down, single-leg press, bilateral squat, balance and reach) was assessed in 15 subjects with PFPS. Secondly, the relationship of the 5 functional tests to pain was assessed in 29 PFPS subjects using Pearson product moment correlations. The limb symmetry index (LSI) was calculated in the 29 PFPS subjects and compared with the group of 11 normal subjects. RESULTS: The 5 functional tests proved to have fair to high intrarater reliability. Intrarater reliability coefficients (ICC 3,1) ranged from.79 to.94. For the PFPS subjects, a statistical difference existed between limbs for the anteromedial lunge, step-down, single-leg press, and balance and reach. All functional tests correlated significantly with pain except for the bilateral squat; values ranged from.39 to.73. The average LSI for the PFPS group was 85%, while the average LSI for the normal subjects was 97%. CONCLUSIONS: The 5 functional tests proved to have good intrarater reliability and were related to changes in pain. Future research is needed to examine interrater reliability, validity, and sensitivity of these clinical tests.

Journal Article↗

PubMed2006

Short-term resistance training and the older adult: the effect of varied programmes for the enhancement of muscle strength and functional performance.

Although it is well recognized that resistance training is an efficient strategy to enhance physical performance in older adults, less is known about the most effective type of resistive exercise or the role of functional training. This study compared the effectiveness of three varied short-term (8 weeks) training protocols on muscle strength and functional performance in older men and women aged 65-84 years. Participants underwent twice-weekly high-velocity varied-resistance training (HV), twice weekly slow to moderate-velocity constant-resistance training (CT), combined once weekly high-velocity varied-resistance and once weekly gymnasium-based functional training (CB) or no training (CO). Dynamic muscle strength (1RM) of six muscle groups was assessed using isotonic equipment and functional performance by a battery of tests. Following 8 weeks of training, whole-body muscle strength increased (P<0.001) by 22.0 +/- 12.5% (mean +/- SD), 21.7 +/- 11.0% and 26.1 +/-14.4% in HV, CT and CB, respectively, compared to CO (-1.8 +/- 7.2%). In between group comparisons, only the HV group displayed greater chair rise ability (P =0.010) than the CO group, while differences among groups approached significance for the fast 6-m walk and the stair climb test (P = 0.017 and 0.041 respectively). Within groups, the HV group significantly improved in stair-climbing and chair rise ability (P</=0.001) while CB improved in the fast 6-m walk (P = 0.003) and CT improved their static balance, as assessed by the functional reach test (P<0.001). This study indicates that twice weekly high-velocity resistance training is superior to strength and combined functional and resistance training for improving some power-orientated functional tasks. Although other functional performance improvements were modest among the training protocols, short-term combined once weekly resistance and once weekly functional training in older adults was as effective in enhancing muscle strength as twice-weekly resistance training. These results have important implications for older adults who are unable or unwilling to frequently attend exercise facilities.

Aged↗

PubMed2003

Muscle strength assessment from functional performance tests: role of body size.

The aim of the study was to test the hypothesis that the body size plays an important role in assessment of muscle ability to exert force by standard functional performance tests. Twenty-one male students were tested on maximal isometric lift, one leg rising, vertical jump, and box lift tests, and the maximal isokinetic strength of hip and knee extensors was also recorded. When indices of the 4 functional performance tests were related to the strength of each of the 2 leg extensor muscle groups, only maximal isometric lift demonstrated positive correlation with knee extensors strength. When muscle strength was corrected for body mass, however, the aforementioned relationship became insignificant, but the 1 leg rising performance demonstrated a positive relationship with knee extensor strength. In addition, maximal isometric lift and 1 leg rising test performance provided positive and negative correlation, respectively, with body mass. The obtained findings were in line with the effects of scale applied on the tested performance. We generally conclude that the assessment of muscle capability to exert force based on some standard functional performance tests could be confounded by the body size effect.

Adult↗

PubMed1996

Continuous-scale physical functional performance in healthy older adults: a validation study.

OBJECTIVE: The continuous-scale physical functional performance test (CS-PFP) is an original instrument designed to provide a comprehensive, in-depth measure of physical function that reflects abilities in several separate physical domains. It is based on a concept of physical function as the integration of physiological capacity, physical performance, and psychosocial factors. SETTING: The test was administered under standard conditions in a hospital facility with a neighborhood setting. The CS-PFP consists of a battery of 15 everyday tasks, ranging from easy to demanding, that sample the physical domains of upper and lower body strength, upper body flexibility, balance and coordination, and endurance. Participants are told to work safely but at maximal effort, and physical functional performance was measured as weight, time, or distance. Scores were standardized and scaled 0 to 12. The test yields a total score and separate physical domain scores. DESIGN: The CS-PFP was evaluated using 148 older adults-78 community dwellers, 31 long-term care facility residents living independently, and 39 residents with some dependence. MAIN OUTCOME MEASURES: Maximal physical performance assessment included measures of maximal oxygen consumption (VO2max), isokinetic strength, range of motion, gait, and balance. Psychosocial factors were measured as self-defined health status using the Sickness Impact Profile (SIP), self-perceived function using the Health Survey (SF36), and Instrumental Activities of Daily Living (IADL). RESULTS: IADL scores were not significantly different among the groups. Test-retest correlations ranged from .84 to .97 and inter-rater reliability from .92 to .99 for the CS-PFP total and 5 domains. Internal consistency was high (Cronbach's alpha, .74 to .97). Both total and individual domain CS-PFP scores were significantly different for the three groups of study participants, increasing with higher levels of independence, supporting construct validity. CS-PFP domain scores were significantly correlated with measures of maximal physical performance (VO2max, strength, etc) and with physical but not emotional aspects of self-perceived function. CONCLUSION: The CS-PFP is a valid, reliable measure of physical function, applicable to a wide range of functional levels, and having minimal floor and ceiling effect. The total and physical domains may be used to evaluate, discriminate, and predict physical functional performance for both research and clinical purposes.

Activities of Daily Living↗