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At least 19 recordsLinked to original sources

PubMed1998

Functional performance of older adults in a long-term care setting.

Motivation has been identified as an important factor in the older adult's ability to perform functional activities. The purpose of this study was to explore functional performance and factors that have an impact on functional performance in nursing home residents. Participants included 44 White older adults from two nursing homes. The majority of the participants were female (84%). The mean age of the participants was 88 +/- 6.4 years and, on the average, they had been institutionalized for 2.85 +/- 2.8 years. Following data reduction of the predictors, two factors--motivation (efficacy beliefs and intrinsic motivation) and lower extremity function (contractures and standing balance)--were identified. In a stepwise multiple regression analysis, these two factors were the only variables that significantly predicted functional performance and accounted for 81% of the variance in function.

Activities of Daily Living↗

PubMed2000

Functional performance and exercise of older adults in long-term care settings.

Performing functional activities and exercising are important for older adults living in long-term care settings. Participation in these activities not only improves and maintains function in older adults but also can improve physical and emotional health and quality of life. The purpose of this study was to explore the variables that influence functional performance and exercise activity in a group of nursing home residents. Participants included 59 residents in a long-term care facility. The mean age of participants was 88 +/- 6.9, and the majority were women (76%), White (97%), and unmarried (76%). Residents participated in a single face-to-face interview. Chart reviews for demographic and health information also were performed. Based on stepwise multiple regression analyses, upper and lower extremity contractures and cognitive status were the only variables that significantly influenced functional performance and accounted for 49% of the variance in function. Self-efficacy and outcome expectations were the only variables to significantly influence exercise behavior and accounted for 57% of the variance in this behavior. These findings can be used to help develop and implement effective restorative nursing care programs in long-term care settings.

Activities of Daily Living↗

PubMed2005

Effects of ankle support on lower-extremity functional performance: a meta-analysis.

UNLABELLED: Clinicians surmise that the application of external ankle support reduces the ability to perform functional skills and movements, but the outcomes from some of these studies have been inconclusive. PURPOSE: To meta-analyze studies regarding the effects of external ankle support on lower-extremity functional performance measures. METHODS: A total of 93 effects from 17 randomized controlled trials utilizing predominantly crossover designs with recreationally active participants and competitive athletes were subjected to a random-effects meta-analysis. The treatment variable was external ankle support with three levels: adhesive tape, lace-up style, and semirigid style. Differences between mean changes in treatment and control groups were computed as standardized effect sizes for sprint, agility, and vertical jump performance with their 90% confidence intervals (CI). Effect sizes >0.20 were considered substantial. RESULTS: The greatest effect of ankle support on performance was a negative effect of lace-up style brace on sprint speed (effect size -0.22, 90% CI -0.47 to 0.03), equivalent to approximately 1% impairment of speed. The other effects of external ankle support on performance were insubstantial, though most were negative, and their lower confidence limits allowed for realistic chances of impaired performance. Substantial true variation between studies, although poorly defined, was also present for some effects, further increasing the likelihood of performance impairment in some settings. CONCLUSIONS: More research is needed to reduce the uncertainty in the effects of external ankle support on performance. In the meantime, it is our opinion that the benefit in preventing injury outweighs the possibility of substantial but small impairment of performance when athletes use external ankle support.

Ankle↗

PubMed2000

Acquired immunodeficiency syndrome wasting, functional performance, and quality of life.

Unintentional loss of weight and lean body mass (wasting) is a major cause of morbidity and mortality in patients with acquired immunodeficiency syndrome (AIDS). Patients with AIDS wasting (AW) often experience reductions in lean body mass, muscle strength, and the ability to perform functions of daily living. Dependence on assistance with activities of daily living may be associated with a lower quality of life (QOL) and higher risk of mortality. These factors suggest that slowing or reversing the loss of lean body mass in AW can improve well-being. Nutritional support or appetite stimulants in the absence of exercise therapy or growth hormone supplementation can increase fat without improving body composition, whereas appropriate exercise programs, androgen therapy, and recombinant human growth hormone (rhGH) therapy may increase lean body mass in patients with AW. Resistance exercise programs can increase muscle strength and lean body mass. In addition, both resistance and endurance (aerobic) exercise augment endogenous growth hormone levels, decrease depression, enhance self-esteem, and may improve immune response. Randomized, double-blind trials have shown that rhGH therapy increases total body weight, lean body mass, exercise capacity, and QOL. In summary, interventions that improve exercise capacity and functional performance may enhance QOL in patients with AW and may reduce mortality in this group.

Activities of Daily Living↗

PubMed2005

Functional-Performance Deficits in Volunteers With Functional Ankle Instability.

Context: Although functional-performance tests are dynamic measures used to assess general lower body function, studies investigating these tests for ankle instability have yielded conflicting results.Objective: To determine if a relationship exists between a measure of functional ankle instability and deficits in functional performance.Design: A case-control study correlating subject performance on a set of lower extremity functional-performance tests with a measure of ankle instability.Setting: University athletic training research laboratory.Patients or Other Participants: We recruited 60 participants (43 females, 17 males, age = 22.4 +/- 4.9 years, height = 169.9 +/- 9.7 cm, mass = 72.6 +/- 16.3 kg; 42 injured, 18 uninjured) to participate in the study. Six questions were used to determine if functional ankle instability was present in each participant. A point was added for each yes response to produce an index that represents a continuous variable of functional ankle instability.Main Outcome Measure(s): Four unilateral hopping tests were used in this study: figure-of-8 hop, side hop, up-down hop, and single hop. For the first 3 tests, the total time was recorded with a handheld stopwatch to the nearest 0.01 second; for the single hop-for-distance test, the distance was recorded to the nearest 0.01 m. Correlations were computed with the functional ankle instability index and each of the 4 functional-performance tests.Results: No relationship was revealed between the functional ankle instability index and single hop for distance or up-down hop, with r values of -.008 and .245, respectively. A significant relationship was found between the functional ankle instability index and the side hop (r = .35, P </= .01) and the figure-of-8 hop (r = .31, P </= .02).Conclusions: A positive relationship existed between functional ankle instability and performance deficits on the side hop and figure-of-8 hop. Conversely, a relationship did not exist between functional ankle instability and frontal-plane functional-performance activities.

Journal Article↗

PubMed2004

Cerebral palsy: correlation of risk factors and functional performance using the Functional Independence Measure for Children (WeeFIM).

We studied the risk factors affecting the functional status of cerebral palsy. A cross-sectional study of 73 children with cerebral palsy was conducted with the Functional Independence Measure for Children (WeeFIM), which assesses functional skills in the domains of self-care, mobility, and cognition. The mean total Functional Independence Measure for Children quotient was 67.5%. The mean subquotients for self-care, mobility, and cognition were 68.3%, 62.7%, and 69.4%, respectively. The risk factors related to the degree of functional dependency were (1) mental retardation (P = .030), (2) epilepsy (P = .005), (3) type of cerebral palsy (P < .001), and (4) severity of cerebral palsy using the Gross Motor Function Classification System (P < .001) (using univariate analysis). However, when using multivariate analysis, only epilepsy (P = .02) and severity status according to the Gross Motor Function Classification System (P < .001) were significantly related. When the etiology was analyzed, only prematurity was significantly associated with better Functional Independence Measure for Children scores using both univariate (P = .022) and multivariate (P = .007) analyses. The functional status of children with cerebral palsy depends on the severity and the presence of epilepsy. Despite impairment, we found that most children with cerebral palsy could achieve functional independence.

Activities of Daily Living↗

PubMed1997

Reliability of lower extremity functional performance tests.

Clinicians routinely have used functional performance tests as an evaluation tool in deciding when an athlete can safely return to unrestricted sporting activities. These practitioners assumed that these tests provide a reliable measure of lower extremity performance; however, little research has been reported on the reliability of these measures. The purpose of this investigation was to determine the reliability of lower extremity functional performance tests. Five male and 15 female volunteers were evaluated using the single hop for distance, triple hop for distance, 6-m timed hop, and cross-over hop for distance as described by Noyes (10). One clinician measured each subject's performance using a standardized protocol and retested subjects in the same manner approximately 48 hours later. The order of testing was randomly determined. Subjects' average and individual scores on each functional performance test were used for statistical analysis. Intraclass correlation coefficients (ICCs) and standard error of measurement (SEM) values based on average day 1 and day 2 scores were used to estimate the reliability of each functional performance test. Intraclass correlation coefficients were .96, .95, and .96, and SEMs were 4.56 cm, 15.44 cm, and 15.95 cm, respectively, for the single hop, triple hop, and cross-over hop for distance tests. An ICC of .66 and SEM of .13 seconds for the 6-m timed hop resulted from limited variability between measurements; however, its small SEM value inferred that the inconsistency of measurement would occur in an acceptably small range. A repeated measures analysis of variance revealed no significant difference ( p > .05) between individual trial scores except for the single hop for distance. We concluded that this difference represented a learning effect not found with the other tests. The results of this investigation demonstrate that clinicians can use functional performance testing to obtain reliable measures of lower extremity performance when using a standardized protocol.

Adult↗

PubMed1977

Smoking and allergic history as correlative risk factors in pulmonary function performance.

Pulmonary function data were compared with smoking history and past personal and family history of asthma, hay fever and eczema in apparently healthy males age 30 to 39. Mean values for FEV1 and MMEF were significantly lower in smokers with a positive allergic history compared to non-allergic smokers.

Adult↗

PubMed2005

Relationship between symptoms and functional performance in COPD.

We studied the relationships among functional performance and three symptoms--dyspnea, fatigue, and sleep difficulty--in a sample of 100 people with chronic obstructive pulmonary disease (COPD). All participants had an FEV(1) 60% or less of the predicted level for age, sex, and height. Consistent with the Theory of Unpleasant Symptoms, dyspnea correlated with both fatigue and sleep difficulty. Dyspnea and fatigue both had moderate negative correlations with functional performance, while sleep difficulty had a small nonsignificant negative correlation with functional performance. After controlling for age and oxygen use, dyspnea was the only symptom to predict variance in functional performance significantly. Of the three symptoms studied, only dyspnea was related to both the other symptoms and to functional performance. Focusing on dyspnea may be the best way to improve both symptom experience and functional performance in people with COPD.

Aged↗

PubMedDate not supplied

Effects of hepatitis C virus infection and its recurrence after liver transplantation on functional performance and health-related quality of life.

Our aim was to examine the effects of hepatitis C virus (HCV) infection, a leading cause of end-stage liver disease, and its recurrence after liver transplantation on functional performance and health-related quality of life. Functional performance, liver function, and HCV recurrence were assessed longitudinally in 75 adult transplant recipients (28 with HCV). Quality of life was reported once after transplantation. Functional performance improved through year 2 (P < 0.001) and then declined in those with HCV, whereas the others remained stable (P = 0.05). Time had a positive effect (beta = 0.22, P = 0.05) and HCV infection had a negative effect (beta = -0.28, P = 0.01) on post-transplant functional performance. Educational level (beta = 0.24, P < 0.05) and recent functional performance (beta = 0.31, P = 0.01) had positive effects on quality of life. HCV recurrence was associated with relatively poorer pretransplant functional performance, a greater rate of improvement through month 3 (P < 0.05), and abnormal transaminase values between years 1 and 2 (P < 0.001). Rehospitalization for recurrent HCV was associated with reduced functional performance (P < 0.05). Functional performance improves with time following liver transplantation, but HCV infection exerts an opposing and comparably strong effect. Post-transplant functional performance, in turn, directly affects post-transplant quality of life. Severe, recurrent HCV illness is associated with reduced functional performance.

Cohort Studies↗

PubMed2003

Modeling the effects of functional performance and post-transplant comorbidities on health-related quality of life after heart transplantation.

BACKGROUND: Health-related quality of life and functional performance are important outcome measures following heart transplantation. This study investigates the impact of pre-transplant functional performance and post-transplant rejection episodes, obesity and osteopenia on post-transplant health-related quality of life and functional performance. METHODS: Functional performance and health-related quality of life were measured in 70 adult heart transplant recipients. A composite health-related quality of life outcome measure was computed via principal component analysis. Iterative, multiple regression-based path analysis was used to develop an integrated model of variables that affect post-transplant functional performance and health-related quality of life. RESULTS: Functional performance, as measured by the Karnofsky scale, improved markedly during the first 6 months post-transplant and was then sustained for up to 3 years. Rejection Grade > or =2 was negatively associated with health-related quality of life, measured by Short Form-36 and reversed Psychosocial Adjustment to Illness Scale scores. Patients with osteopenia had lower Short Form-36 physical scores and obese patients had lower functional performance. Path analysis demonstrated a negative direct effect of obesity (beta = - 0.28, p < 0.05) on post-transplant functional performance. Post-transplant functional performance had a positive direct effect on the health-related quality of life composite score (beta = 0.48, p < 0.001), and prior rejection episodes grade > or =2 had a negative direct effect on this measure (beta = -0.29, p < 0.05). Either directly or through effects mediated by functional performance, moderate-to-severe rejection, obesity and osteopenia negatively impact health-related quality of life. These findings indicate that efforts should be made to devise immunosuppressive regimens that reduce the incidence of acute rejection, weight gain and osteopenia after heart transplantation.

Bone Diseases, Metabolic↗

PubMed2002

Chronic Ankle Instability Does Not Affect Lower Extremity Functional Performance.

OBJECTIVE: To determine if functional performance is impaired in individuals with self-reported chronic ankle instability. DESIGN AND SETTING: We used a between-groups design to assess 3 functional variables. All data were collected at a Division III college and a military academy. Before testing, all subjects performed a 5-minute warm-up, followed by a series of stretches for the lower extremity muscles. Subjects then performed cocontraction, shuttle run, and agility hop tests in a counterbalanced fashion. Three trials for each functional test were completed and averaged for analysis. SUBJECTS: Twenty men with a history of at least 1 significant ankle sprain and episodes of at least 1 repeated ankle injury or feelings of instability or "giving way" were compared with 20 men with no prior history of ankle injury. Subjects were matched by age, height, weight, and activity level. MEASUREMENTS: Time to completion was measured in seconds for the cocontraction and the shuttle run tests. The agility hop test was measured on an error point scale. RESULTS: Using 3 separate, independent, 2-tailed t tests, we found no significant difference between groups for the cocontraction (P =.452), shuttle run (P =.680), or agility hop (P =.902) tests. CONCLUSIONS: Chronic ankle instability is a subjectively reported phenomenon defined as the tendency to "give way" during normal activity. Although athletes commonly complain of subjective symptoms associated with chronic ankle instability, our findings suggest that these symptoms do not negatively influence actual functional performance. Future researchers should evaluate other, more demanding functional-performance tests to further substantiate these findings.

Journal Article↗

PubMed2005

Effects of a heavy and a moderate resistance training on functional performance in older adults.

Resistance training can improve strength and functional performance, but there is little information about the effect of training intensity on functional performance in older adults. The purpose of this study was to determine the effect of 12 weeks of heavy (80% of 1 repetition maximum [1RM]) and moderate (60% of 1RM) resistance training on functional performance in healthy, inactive older adults, ages 60-74 years. Volunteer subjects were assigned randomly to a control group (CS, n = 10), heavy resistance training group (HRT, n = 11), or moderate resistance training group (MRT, n = 12) and participated in 12 weeks of strength training, 3 times per week. Performance measurements included 1RM lower-body strength, chair-rising time, walking velocity, stair-climbing time, and flexibility. Significant differences between HRT and MRT were found for 1RM strength of the lower limbs after the training period. Functional performance improved similarly for both HRT and MRT after the training period. Functional performance can be improved significantly with either heavy or moderate resistance training, without significant differences in the effectiveness of the 2 training protocols.

Aged↗

PubMed1989

The Bay Area Functional Performance Evaluation: development and standardization.

The Bay Area Functional Performance Evaluation (BaFPE) was developed in 1977-1978 to meet the need for a reliable and valid instrument for assessing the general functional performance of patients treated in psychiatric occupational therapy. It consists of two subtests, the Task-Oriented Assessment and the Social Interaction Scale. These subtests evaluate two aspects of general functional performance--task-oriented and social behavior--that are important in assessing clients with emotional, cognitive, or behavioral deficits. This article traces the instrument's standardization over a 10-year period of development and includes a discussion of its theoretical premises, its content, and the revisions to date. Research on the reliability and validity of the BaFPE is summarized.

Humans↗

PubMed1993

Age differences in functional performance.

We compared the functional performance of 20 young adult women and 20 older adult women on two types of tasks. One type of task was normal instrumental activities of daily living (e.g., meal preparation, home maintenance) that were meaningful, familiar, and well practiced. The other type was a contrived, relatively unfamiliar task of wrapping a package. Although young and old women did not differ significantly in their familiarity with the two tasks, results from two repeated measures MANOVAs revealed a significant age difference in both activities. This finding suggests that older adults show age-related decline with tasks even when those tasks are familiar, practiced, and ecologically valid.

Activities of Daily Living↗

PubMed2006

Cross-sectional relationship between physical fitness components and functional performance in older persons living in long-term care facilities.

BACKGROUND: The age-related deterioration of physiological capacities such as muscle strength and balance is associated with increased dependence. Understanding the contribution of physical fitness components to functional performance facilitates the development of adequate exercise interventions aiming at preservation of function and independence of older people. The aim of the study was to investigate the relationship between physical fitness components and functional performance in older people living in long-term care facilities. METHODS: Design cross-sectional study. Subjects 226 persons living in long-term care facilities (mean age: 81.6 +/- 5.6). Outcome measures Physical fitness and functional performance were measured by performance-based tests. RESULTS: Knee and elbow extension strength were significantly higher in men (difference = 44.5 and 50.0 N, respectively), whereas women were more flexible (difference sit & reach test = 7.2 cm). Functional performance was not significantly different between the genders. In men, motor coordination (eye-hand coordination) and measures of strength were the main contributors to functional performance, whereas in women flexibility (sit and reach test) and motor coordination (tandem stance and eye-hand coordination) played a major role. CONCLUSION: The results of this study show that besides muscle strength, fitness components such as coordination and flexibility are associated with functional performance of older people living in long-term care facilities. This suggests that men and women living in long-term care facilities, differ considerably concerning the fitness factors contributing to functional performance. Women and men may, therefore, need exercise programs emphasizing different fitness aspects in order to improve functional performance.

Activities of Daily Living↗

PubMed1996

The relationship of postural sway to sensorimotor function, functional performance, and disability in the elderly.

OBJECTIVE: To examine the relationship of postural sway to sensorimotor impairment, functional performance, and self-reported disability. DESIGN: Cross-sectional cohort. SETTING: Department of Veterans' Affairs Medical Center. PATIENTS: One hundred community-dwelling elderly unable to climb stairs step over step. MAIN OUTCOME MEASURES: Postural sway (area of ellipse and path length, eyes open and closed), sensorimotor (strength, sensation, range of motion, central processing time), functional performance (functional reach, timed gait, mobility skills, endurance), and disability (MOS-SF36, Falls Efficacy Scale [FES]). RESULTS: Postural sway area measures correlated with sensorimotor measures: (1) During eyes-closed conditions, increased sway occurs in individuals with sensory deficits (p < .05); (2) Sway was positively correlated with tibialis anterior latency (p < .05); (3) Sway area measures increased with increased strength (p < .05). The sway/strength relationship may be explained by week subjects improving their stability by limiting rather than increasing sway. Sway was not significantly correlated with any measures of physical performance. Sway was correlated with some measures of disability: (1) Eyes-closed measures of postural sway were correlated with FES scores (p < .05); (2) Sway was not correlated with the MOS-36 physical functioning question. When controlling for functional measures, eyes-closed measures of sway significantly predicted FES scores (p < .03). CONCLUSIONS: Measures of postural sway are more likely capturing sensorimotor deficits rather than differentiating functional performance abilities, and the relationship between postural sway and self-reported disability is inconsistent.

Activities of Daily Living↗

PubMedDate not supplied

Use of self-efficacy and dyspnea perceptions to predict functional performance in people with COPD.

This correlational and comparative study explored whether self-reports of self-efficacy and dyspnea perceptions predict the perceived level of functional performance in adults who have chronic obstructive pulmonary disease (COPD). The convenience sample included 97 Caucasian men (52) and women (45). Participants had to have a forced expiratory volume in 1 second (FEV1) of less than 70% predicted, and a FEV1/forced vital capacity (FVC) of less than 70%. Participants were recruited from pulmonary function laboratories and from better breather support groups in a Midwestern state. Three standardized, self-report instruments, COPD Self-Efficacy Scale (CSES), the Pulmonary Functional Status and Dyspnea Questionnaire (PFSDQ), and Functional Performance Inventory (FPI) were used to measure the participants' self-report of their perceptions of self-efficacy, dyspnea, and functional performance. Dyspnea predicted 38.1% of the variance in functional performance, with self-efficacy contributing an additional 6.5% to the variance in the total sample. Self-efficacy predicted 36.5% of the variance in functional performance in men, with dyspnea contributing an additional 7.2% to the variance. However, in women, only dyspnea was a significant predictor of functional performance, at 48.5% when both dyspnea and self-efficacy were entered as independent variables. To improve patients' perceptions of functional performance, nurses can use methods such as breathing techniques and upper- and lower-body exercises that increase optimal management of dyspnea. Nurses may increase the self-efficacy of managing dyspnea by helping patients master breathing techniques and exercise through coaching and providing vicarious experiences through patient support groups or pulmonary rehabilitation programs.

Dyspnea↗